Acute ischemic stroke from fibrocartilaginous embolism to the middle cerebral artery

Gabriel Toro-Gonzaález, Lydia Navarro-Román, Gustavo C. Román, Jaime Cantillo, Benito Serrano, Manuel Herrera, Ignacio Vergara

Research output: Contribution to journalArticle

24 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)738-740
Number of pages3
JournalStroke
Volume24
Issue number5
DOIs
StatePublished - May 1993

Keywords

  • Cerebral ischemia
  • Embolism
  • Trauma

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

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