Neonatal Arterial Ischemic Stroke Secondary to Carotid Artery Dissection: A Case Report and Systematic Literature Review - 12/01/23
, Maria Federica Pelizza, MD a, Jacopo Norberto Pin, MD a, Anna Zarpellon, MD a, Clarissa Tona, MD a, Giorgio Perilongo, MD, PhD a, Paolo Simioni, MD, PhD d, Irene Toldo, MD, PhD a, Giacomo Talenti, MD e, Stefano Sartori, MD, PhD a, c, fAbstract |
Background |
Carotid artery (CA) dissection is a rare etiology of neonatal arterial ischemic stroke (NAIS).
Methods |
We describe one novel case and conduct a systematic literature review on NAIS attributed to CA dissection, to collect data on its clinical-radiological presentation, treatment, and outcome.
Results |
Eight published cases of NAIS attributed to CA dissection were identified and analyzed with our case. All patients (nine of nine) were born at term, and eight of nine experienced instrumental/traumatic delivery or urgent Caesarean section. None had fetal problems during pregnancy or thrombophilia. Signs and symptoms at presentation (between days of life 0 and 6) included seizures (eight of nine), respiratory distress or irregular breathing (five of nine), hyporeactivity, decreased consciousness or irritability (four of nine), and focal neurological signs (two of nine). At magnetic resonance imaging (MRI), stroke was unilateral in seven of nine and extensive in five of nine. CA dissection was documented by neuroimaging or at postmortem studies (seven of nine), and hypothesized by the treating physicians based on delivery and neuroradiology characteristics (in the remaining two of nine). Antithrombotic treatment was used in two of nine. According to available follow-up, one of eight died at age seven days, seven of eight had neurological/epileptic sequelae, and CA recanalization occurred in three of four.
Conclusions |
NAIS attributed to CA dissection is rarely identified in the literature, often preceded by traumatic/instrumental delivery, presenting with seizures and systemic signs/symptoms, and often characterized by extensive MRI lesions and neurological sequelae. Definite evidence and recommendations on antithrombotic treatment are lacking.
Le texte complet de cet article est disponible en PDF.Keywords : Arterial ischemic stroke, Neonatal, Perinatal, Carotid artery dissection, Carotid occlusion, Pediatric
Plan
| Funding: The present study did not receive any funding. |
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| Disclosures: The authors report no disclosures. |
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| Author contribution: Laura Baggio carried out the literature review and drafted the paper. Margherita Nosadini carried out the literature review and contributed to the last version of the manuscript. Stefano Sartori provided senior support for the article conceptualization and contributed to the last version of the manuscript. Giacomo Talenti provided neuroradiological guidance. Maria Federica Pelizza, Jacopo Norberto Pin, Anna Zarpellon, Clarissa Tona, Irene Toldo, Giorgio Perilongo, Paolo Simioni: supervised the literature review and contributed to the critical revision of the manuscript. |
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| Conflict of interest: The authors report no disclosures and no conflict of interest. |
Vol 139
P. 13-21 - février 2023 Retour au numéro
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