Journal article
Perinatal arterial ischemic stroke related to carotid artery occlusion.
- Fluss J Pediatric Neurology Unit, Pediatric Subspecialities Service, Children's Hospital, Geneva University Hospitals, Switzerland. Electronic address: joel.fluss@hcuge.ch.
- Garcia-Tarodo S Pediatric Neurology Unit, Pediatric Subspecialities Service, Children's Hospital, Geneva University Hospitals, Switzerland.
- Granier M Neonatal Unit, Sud-Francilien Hospital Centre, Corbeil, France.
- Villega F Pediatric Neurology, Children's Hospital, Bordeaux University Hospital, Bordeaux, France.
- Ferey S Unit of Pediatric Radiology, Children's Hospital, Geneva University Hospitals, Switzerland.
- Husson B French Centre for Pediatric Stroke and Pediatric Radiology, Bicêtre University Hospital Centre, Le Kremlin-Bicêtre, France.
- Kossorotoff M French Centre for Pediatric Stroke, Pediatric Neurology Department, APHP-Necker-Enfants Malades, University Hospital, Paris, France.
- Muehlethaler V Neonatal Unit, Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland.
- Lebon S Pediatric Neurology Unit, Department of Pediatrics, Lausanne University Hospital, Switzerland.
- Chabrier S French Centre for Pediatric Stroke, University Hospital Centre of Saint-Etienne, 42055 Saint-Etienne Cedex 2, France.
- 2016-03-31
Published in:
- European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. - 2016
Carotid occlusion
Dissection
Neonatal arterial ischemic stroke
Perinatal stroke
Placental thromboembolism
Arterial Occlusive Diseases
Brain
Brain Ischemia
Carotid Arteries
Carotid Artery Diseases
Cerebral Angiography
Cerebral Palsy
Developmental Disabilities
Epilepsies, Partial
Female
Humans
Infant, Newborn
Intellectual Disability
Magnetic Resonance Angiography
Male
Placenta
Pregnancy
Risk Factors
Stroke
English
BACKGROUND
The aetiology of perinatal arterial ischemic stroke remains speculative. It is however widely accepted that the aetiology is multifactorial, involving various maternal, placental, foetal and neonatal risk factors. A resulting thromboembolic process is hypothesized and the placenta identified as the most plausible source. An arteriopathy, as observed in a significant proportion of childhood ischemic stroke, is thought to be rare.
METHODS
We report here five cases of perinatal stroke that differ from the vast majority by documented carotid occlusion, and add eleven other similar cases from the literature.
RESULTS
In the majority, an intraluminal thrombus of placental origin is the most probable hypothesis, while in the remaining ones, one can reasonably presume a direct vessel wall injury related to a traumatic delivery, yet generally unproven by imaging.
CONCLUSION
We hypothesize that most of these cases share similar pathophysiology with the more common perinatal arterial ischemic stroke but differ by a persistent identified thrombus in the carotid artery at the time of first imaging, leading to a more severe and extended ischemic damage responsible for an adverse neurological outcome.
The aetiology of perinatal arterial ischemic stroke remains speculative. It is however widely accepted that the aetiology is multifactorial, involving various maternal, placental, foetal and neonatal risk factors. A resulting thromboembolic process is hypothesized and the placenta identified as the most plausible source. An arteriopathy, as observed in a significant proportion of childhood ischemic stroke, is thought to be rare.
METHODS
We report here five cases of perinatal stroke that differ from the vast majority by documented carotid occlusion, and add eleven other similar cases from the literature.
RESULTS
In the majority, an intraluminal thrombus of placental origin is the most probable hypothesis, while in the remaining ones, one can reasonably presume a direct vessel wall injury related to a traumatic delivery, yet generally unproven by imaging.
CONCLUSION
We hypothesize that most of these cases share similar pathophysiology with the more common perinatal arterial ischemic stroke but differ by a persistent identified thrombus in the carotid artery at the time of first imaging, leading to a more severe and extended ischemic damage responsible for an adverse neurological outcome.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ejpn.2016.03.003
- PMID 27025300
- Persistent URL
- https://sonar.ch/global/documents/46350
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