Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
Login Abbonamenti Pubblicazioni Carrello Registrazione Perché registrarsi? Contatti

Caso contributivo

PDF

Stroke cerebellare e dissezione dell’arteria vertebrale in una adolescente

Cerebellar stroke and vertebral artery dissection in an adolescent

Elena Manzotti1, Valentina Bianco1, Beatrice Filippini2, Gianluca Vergine2, Lorenzo Iughetti1-3, Alberto Marsciani2
1Scuola di Specializzazione in Pediatria, Università di Modena e Reggio Emilia
2UO di Pediatria, Ospedale Infermi Rimini, AUSL della Romagna
3Unità Operativa di Pediatria, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Azienda Ospedaliero-Universitaria Policlinico, Modena

Aprile 2015

Abstract
A 13-year-old girl presented with progressive frontal he-adache, dizziness, vomiting and hypotonia, with heat sen-sation and hyperidrosis. She referred a “contraction” of the neck some days before, while she was doing gymna-stics. The only physical sign was coarse tremor of the left lower limb to the test Mingazzini. Laboratory and radio-logic exams were normal, but cerebral MRI and angio-MRI put in evidence some ischemic spots in the left cere-bellar emisphere and cerebellar vermis; they originated from a dissection of the vertebral artery, evidenced by an angio-MRI of the supra-aortic arteries. After 10 months of low dose acetylsalicylic acid therapy, symptoms resol-ved almost completely, with no new ischemic events. The cerebellar lesions were resolving, as well as the small pseudoaneurysm at the level of dissection. Cerebellar stroke is rare in children, the spontaneous dissection of the vertebral arteries can be one of the possible etiolo-gies, even with no history of cervical trauma.
Contenuto riservato

Per leggere l'articolo è necessario effettuare il login.

Bibliografia
Yaghi S, Maalouf N, Keyrouz SG. Cervical artery dissection: risk factors, treatment, and outcome; a 5-year experience from a tertiary care center. Int J Neurosci 2012;122:40-4. Thanvi B, Munshi SK, Dawson SL, Robinson TG. Carotid and vertebral artery dissection syndromes. Postgrad Med J 2005;81:383-8. Mohan IV. Current optimal assessment and management of carotid and vertebral spontaneous and traumatic dissection. Angiology 2014;65(4):274-83. Perry BC, Al-Ali F. Spontaneous cervical artery dissection: the borgess classification. Front Neurol 2013;4:133. Grassi M, Amato D, Ricciardelli P, et al. Sindrome di Wallenberg in età pediatrica. Medico e Bambino pagine elettroniche 2013;16(6). Barinagarrementeria F, Amaya LE, Cantù C. Causes and mechanisms of cerebellar infarction in young patients. Stroke 1997;28:2400-4. Kawakami Y1, Koizumi SY, Kuwabara K, et al. An 8-year-old-boy with vertebral artery dissection with cerebellar ataxia featuring suspected vertebral artery hypoplasia. Brain Dev 2009;31:326-30. Lin JJ, Lin KL, Chou ML, Wong AMC, Wang HS. Cerebellar infarction in the territory of the superior cerebellar artery in children. Pediatr Neurol 2007;37:435-7. Rozen TD. Vanishing cerebellar infarcts in a migraine patient. Cephalgia 2007;27:557-60. Goyal MS, Derdeyn CP. The diagnosis and management of supraaortic arterial dissections. Curr Opin Neurol 2009;22:80-9. Schievink WI. The treatment of spontaneous carotid and vertebral artery dissections. Curr Opin Cardiol 2000;15:316-21.