Abstract
Though a rare cause of stroke in the general population, in almost one quarter of young patients affected by stroke cervical artery dissection (CAD) is the underlying cause. Among these cases "spontaneous" dissections, intended as non-traumatic, represent about 34% of posterior circulation arterial dissection in patients aged less than 18 years. We here describe the case of a seven-year-old boy who developed a spontaneous vertebral artery dissection (VAD) leading to occipito-mesial, thalamo-capsular and cerebellar infarction. Once a traumatic origin was excluded, clinical history and laboratory findings were further analysed: fever associated with tonsillitis during the previous week, raised inflammatory indices, a throat culture positive for beta haemolysing Streptococcus group A and high titres of streptococcal antibodies were found. This case suggests that patients with CAD referred as spontaneous deserve extensive analysis. Subjects presenting with a dissection and an underlying infection are likely to have a hyperinflammatory response (although further experience is needed). In these patients immediate start of antibiotic therapy, treatment with anti-inflammatory drugs and further a lifelong prophylaxis with antibiotics before any invasive procedure are strongly recommended.
| Original language | English |
|---|---|
| Pages (from-to) | 364-368 |
| Number of pages | 5 |
| Journal | Neurological Sciences |
| Volume | 27 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 2006 |
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Keywords
- Infection
- Non-traumatic
- Spontaneous
- Therapy
- Vertebral artery dissection
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)
Cite this
Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition? / Bacigaluppi, Susanna; Rusconi, R.; Rampini, P.; Annoni, F.; Zavanone, M. L.; Carnelli, V.; Gaini, S. M.
In: Neurological Sciences, Vol. 27, No. 5, 11.2006, p. 364-368.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition?
AU - Bacigaluppi, Susanna
AU - Rusconi, R.
AU - Rampini, P.
AU - Annoni, F.
AU - Zavanone, M. L.
AU - Carnelli, V.
AU - Gaini, S. M.
PY - 2006/11
Y1 - 2006/11
N2 - Though a rare cause of stroke in the general population, in almost one quarter of young patients affected by stroke cervical artery dissection (CAD) is the underlying cause. Among these cases "spontaneous" dissections, intended as non-traumatic, represent about 34% of posterior circulation arterial dissection in patients aged less than 18 years. We here describe the case of a seven-year-old boy who developed a spontaneous vertebral artery dissection (VAD) leading to occipito-mesial, thalamo-capsular and cerebellar infarction. Once a traumatic origin was excluded, clinical history and laboratory findings were further analysed: fever associated with tonsillitis during the previous week, raised inflammatory indices, a throat culture positive for beta haemolysing Streptococcus group A and high titres of streptococcal antibodies were found. This case suggests that patients with CAD referred as spontaneous deserve extensive analysis. Subjects presenting with a dissection and an underlying infection are likely to have a hyperinflammatory response (although further experience is needed). In these patients immediate start of antibiotic therapy, treatment with anti-inflammatory drugs and further a lifelong prophylaxis with antibiotics before any invasive procedure are strongly recommended.
AB - Though a rare cause of stroke in the general population, in almost one quarter of young patients affected by stroke cervical artery dissection (CAD) is the underlying cause. Among these cases "spontaneous" dissections, intended as non-traumatic, represent about 34% of posterior circulation arterial dissection in patients aged less than 18 years. We here describe the case of a seven-year-old boy who developed a spontaneous vertebral artery dissection (VAD) leading to occipito-mesial, thalamo-capsular and cerebellar infarction. Once a traumatic origin was excluded, clinical history and laboratory findings were further analysed: fever associated with tonsillitis during the previous week, raised inflammatory indices, a throat culture positive for beta haemolysing Streptococcus group A and high titres of streptococcal antibodies were found. This case suggests that patients with CAD referred as spontaneous deserve extensive analysis. Subjects presenting with a dissection and an underlying infection are likely to have a hyperinflammatory response (although further experience is needed). In these patients immediate start of antibiotic therapy, treatment with anti-inflammatory drugs and further a lifelong prophylaxis with antibiotics before any invasive procedure are strongly recommended.
KW - Infection
KW - Non-traumatic
KW - Spontaneous
KW - Therapy
KW - Vertebral artery dissection
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UR - http://www.scopus.com/inward/citedby.url?scp=37849186441&partnerID=8YFLogxK
U2 - 10.1007/s10072-006-0712-x
DO - 10.1007/s10072-006-0712-x
M3 - Article
C2 - 17122949
AN - SCOPUS:37849186441
VL - 27
SP - 364
EP - 368
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 5
ER -