Acute ischemic stroke from fibrocartilaginous embolism to the middle cerebral artery.

Abstract:

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.

journal_name

Stroke

journal_title

Stroke

authors

Toro-González G,Navarro-Román L,Román GC,Cantillo J,Serrano B,Herrera M,Vergara I

doi

10.1161/01.str.24.5.738

subject

Has Abstract

pub_date

1993-05-01 00:00:00

pages

738-40

issue

5

eissn

0039-2499

issn

1524-4628

journal_volume

24

pub_type

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