TY - JOUR
T1 - Acute ischemic stroke from fibrocartilaginous embolism to the middle cerebral artery
AU - Toro-Gonzaález, Gabriel
AU - Navarro-Román, Lydia
AU - Román, Gustavo C.
AU - Cantillo, Jaime
AU - Serrano, Benito
AU - Herrera, Manuel
AU - Vergara, Ignacio
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1993/5
Y1 - 1993/5
N2 - Background and Purpose: Fibrocartilaginous embolism from the nucleus pulposus has been reported as a rare cause of spinal cord ischemia. We were unable to find previous reports of embolism from this source to cerebral arteries. Case Description: A previously healthy 17-year-old girl fell during a basketball game. Left hemiparesis and unresponsiveness developed followed by signs of right uncal herniation and death over a 3-day period. There was no evidence of neck, head, or spine trauma, and cardiac evaluation was normal. Neuropathological examination showed extensive ischemic infarction of the right middle cerebral artery territory, brain edema, and herniation. Complete embolic occlusion of the right middle cerebral artery by fibrocartilaginous material, consistent with nucleus pulposus, was documented. Small, terminal coronary artery branches also showed embolism by the same material and limited areas of myocardial infarction. Conclusions: Acute cerebral embolism after minor trauma in a young patient may be rarely due to fibrocartilaginous embolism from the nucleus pulposus. The pathogenesis of this problem remains poorly understood, but systemic embolism appeared to have occurred in this case.
AB - Background and Purpose: Fibrocartilaginous embolism from the nucleus pulposus has been reported as a rare cause of spinal cord ischemia. We were unable to find previous reports of embolism from this source to cerebral arteries. Case Description: A previously healthy 17-year-old girl fell during a basketball game. Left hemiparesis and unresponsiveness developed followed by signs of right uncal herniation and death over a 3-day period. There was no evidence of neck, head, or spine trauma, and cardiac evaluation was normal. Neuropathological examination showed extensive ischemic infarction of the right middle cerebral artery territory, brain edema, and herniation. Complete embolic occlusion of the right middle cerebral artery by fibrocartilaginous material, consistent with nucleus pulposus, was documented. Small, terminal coronary artery branches also showed embolism by the same material and limited areas of myocardial infarction. Conclusions: Acute cerebral embolism after minor trauma in a young patient may be rarely due to fibrocartilaginous embolism from the nucleus pulposus. The pathogenesis of this problem remains poorly understood, but systemic embolism appeared to have occurred in this case.
KW - Cerebral ischemia
KW - Embolism
KW - Trauma
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U2 - 10.1161/01.str.24.5.738
DO - 10.1161/01.str.24.5.738
M3 - Article
C2 - 8488530
AN - SCOPUS:0027243340
SN - 0039-2499
VL - 24
SP - 738
EP - 740
JO - Stroke
JF - Stroke
IS - 5
ER -