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
Strokejournal_title
Strokeauthors
Toro-González G,Navarro-Román L,Román GC,Cantillo J,Serrano B,Herrera M,Vergara Idoi
10.1161/01.str.24.5.738subject
Has Abstractpub_date
1993-05-01 00:00:00pages
738-40issue
5eissn
0039-2499issn
1524-4628journal_volume
24pub_type
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