Extracranial vertebral artery dissection in children: natural history and management

Simonnet, H; Deiva, Kumaran; Bellesme, Céline; Cabasson, Sébastien; Husson, B.; Toulgoat, F.; Théaudin, Marie; Ducreux, D.; Tardieu, Marc; Saliou, Guillaume

doi:10.1007/s00234-015-1520-x

Cited by 11 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The angiographic course of the disease is quite similar to FCA, once again with a monophasic course towards stability/regression/artery occlusion, without long-term recurrence. The preferred modality of stroke recurrence prevention is anticoagulation in this setting [62,63]. Carotid artery dissection is not frequent in young children.…”

Section: The Predominance Of Arteriopathic Causes Of Ais In Childrenmentioning

confidence: 99%

Arterial ischemic stroke in non-neonate children: Diagnostic and therapeutic specificities

Kossorotoff

Chabrier

Dong³

et al. 2020

Revue Neurologique

View full text Add to dashboard Cite

Section: The Predominance Of Arteriopathic Causes Of Ais In Childrenmentioning

confidence: 99%

Arterial ischemic stroke in non-neonate children: Diagnostic and therapeutic specificities

Kossorotoff

Chabrier

Dong³

et al. 2020

Revue Neurologique

View full text Add to dashboard Cite

“…Interestingly, in literature, the most described etiology of posteror stroke identified in children without NF2 is vertebral artery dissection (VAD) and its determinants are not well known ( 22 , 23 ). Due to this fact, it is important to include the vetrebro-basilar territory in diagnostic work-up to avoid underestimation of VAD.…”

Section: Discussionmentioning

confidence: 99%

Cerebrovascular Insult as Presenting Symptom of Neurofibromatosis Type 2 in Children, Adolescents, and Young Adults

et al. 2018

View full text Add to dashboard Cite

Background and Purpose: Neurofibromatosis Type 2 (NF2) is an autosomal-dominant tumor-prone disorder characterized by the manifestations of central nervous system lesions. However, the first clinical signs of disease are often non-tumorous. Cerebrovascular insults are known in NF2, however, not yet described as first symptom in young NF2 patients.Methods: Magnetic resonance image scans of 298 NF2 patients treated in our neurofibromatosis center in Tübingen from 2003 to 2017 were retrospectively evaluated focusing on presence of aneurysms and ischemic stroke. Clinical data were used to clarify whether or not ischemic stroke or aneurysm rupture were the first presentation of disease. Blood of the patients were subjected to genetic screening for constitutional NF2 mutations.Results: We identified 5 cases under age of 25 years with aneurysms or ischemic stroke. Among them three had ischemic strokes of the brain stem and one aneurysmal subarachnoid hemorrhage as the first symptom of the disease. Incidental finding of 2 intracranial aneurysm occurred in one patient. All aneurysms were clipped. Patients with ischemia suffered from dysarthria, gait disturbances, dizziness, and hemiparesis. Residual signs of hemiparesis and dysarthria persisted in one patient. All others fully recovered from the cerebrovascular insult. Bilateral vestibular schwannomas and intracranial meningiomas were found in all five patients.Conclusions: A cerebrovascular insult in the vertebrobasilar territory may occur as first symptom of disease in young NF2 patients. The brain stem seems to be especially prone to ischemic stroke. Multicenter studies on large NF2 cohorts are needed to determine the prevalence and pattern of cerebrovascular insults and disease in NF2 patients.

show abstract

“…Interestingly, vertebral dissection, which is a typical cause of Wallenberg syndrome in adulthood, and occasionally reported in children and adolescent in particular after mild trauma and sport injuries, is not clearly associated in this age-group with Wallenberg syndrome. 13,14 It must be however, recognized that noninvasive imaging techniques can fail to detect intra-and extracranial artery dissections. 6,14 In conclusion, acute vertigo in childhood, particularly after head trauma, imposes a complete neurological and vestibular examination.…”

Section: Discussionmentioning

confidence: 99%

Wallenberg Syndrome: An Exceptional Cause of Acute Vertigo in Children

et al. 2015

View full text Add to dashboard Cite

The assessment of acute vertigo in childhood is often challenging, but fortunately a central cause is rarely identified. We present the case of a 7-year-old boy who developed, after a mild head trauma, a rotary vertigo associated with nausea and vomiting. A posttraumatic peripheral vestibular dysfunction was first suspected but not confirmed by an otoneurological evaluation. When subtle neurological signs were elicited, a brain magnetic resonance imaging was promptly requested. This showed a small infarct on the lateral posterior left part of the medulla oblongata of the brainstem, typical of Wallenberg syndrome. Vascular imaging was normal and no defined etiology was found. The child was started on prophylactic acetylsalicylic acid. The rapid disappearance of vertigo was noted. On follow-up at 6 months, there has been no recurrence and neurological examination was fully normal. Our case extends the differential diagnosis of acute vertigo in childhood that rarely includes the possibility of a brainstem infarct whose recognition through appropriate clinical examination is nevertheless capital for appropriate investigations and management.

show abstract

Extracranial vertebral artery dissection in children: natural history and management

Cited by 11 publications

References 30 publications

Arterial ischemic stroke in non-neonate children: Diagnostic and therapeutic specificities

Arterial ischemic stroke in non-neonate children: Diagnostic and therapeutic specificities

Cerebrovascular Insult as Presenting Symptom of Neurofibromatosis Type 2 in Children, Adolescents, and Young Adults

Wallenberg Syndrome: An Exceptional Cause of Acute Vertigo in Children

Contact Info

Product

Resources

About