Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition?

Susanna Bacigaluppi, R. Rusconi, P. Rampini, F. Annoni, M. L. Zavanone, V. Carnelli, S. M. Gaini

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)364-368
Number of pages5
JournalNeurological Sciences
Volume27
Issue number5
DOIs
Publication statusPublished - Nov 2006

Fingerprint

Vertebral Artery Dissection
Dissection
Arteries
Stroke
Tonsillitis
Antibiotic Prophylaxis
Streptococcus pyogenes
Pharynx
Infarction
Anti-Inflammatory Agents
Fever
Anti-Bacterial Agents
Antibodies
Therapeutics
Infection
Pharmaceutical Preparations
Population

Keywords

  • Infection
  • Non-traumatic
  • Spontaneous
  • Therapy
  • Vertebral artery dissection

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Bacigaluppi, S., Rusconi, R., Rampini, P., Annoni, F., Zavanone, M. L., Carnelli, V., & Gaini, S. M. (2006). Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition? Neurological Sciences, 27(5), 364-368. https://doi.org/10.1007/s10072-006-0712-x

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 journalArticle

Bacigaluppi, S, Rusconi, R, Rampini, P, Annoni, F, Zavanone, ML, Carnelli, V & Gaini, SM 2006, 'Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition?', Neurological Sciences, vol. 27, no. 5, pp. 364-368. https://doi.org/10.1007/s10072-006-0712-x
Bacigaluppi S, Rusconi R, Rampini P, Annoni F, Zavanone ML, Carnelli V et al. Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition? Neurological Sciences. 2006 Nov;27(5):364-368. https://doi.org/10.1007/s10072-006-0712-x
Bacigaluppi, Susanna ; Rusconi, R. ; Rampini, P. ; Annoni, F. ; Zavanone, M. L. ; Carnelli, V. ; Gaini, S. M. / Vertebral artery dissection in a child. Is "spontaneous" still an appropriate definition?. In: Neurological Sciences. 2006 ; Vol. 27, No. 5. pp. 364-368.
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