7 research outputs found
Recurrent Strokes due to Transient Vasospasms of the Extracranial Internal Carotid Artery
Vasospasms of the intracranial arteries are a well-known complication of subarachnoid hemorrhage and are also frequently encountered in other disorders such as migraine, cerebral vasculitis or reversible cerebral vasoconstriction syndrome. In contrast, recurrent spontaneous vasospasms of the extracranial circulation appear to be extremely rare and have most often been associated with migraine. We present a patient with recurrent strokes due to spontaneous transient vasospastic occlusions of the internal carotid artery (ICA) without migraine over a time period of at least 13 years. Initially, the patient had presented with a bilateral ICA occlusion and a cerebral infarct on the right side. While the right ICA remained occluded, a reopening of the left ICA could be detected 3 days after this initial event. In subsequent years, both duplex sonography and magnetic resonance angiography revealed recurrent occlusions of the left ICA, which resolved spontaneously within days. This case and other rare previous reports indicate that recurrent non-migrainous vasospasms of the extracranial carotid artery likely reflect a distinct entity which can cause ischemic strokes
SiPP (Stroke in Pregnancy and Postpartum): A prospective, observational, international, multicentre study on pathophysiological mechanisms, clinical profile, management and outcome of cerebrovascular diseases in pregnant and postpartum women
Rationale: Cerebrovascular diseases associated with pregnancy and postpartum period are uncommon; however, they
can have an important impact on health of both women and foetus or newborn.
Aims: To evaluate the frequency, characteristics and management of cerebrovascular events in pregnant/postpartum
women, to clarify pathophysiological mechanisms underlying the occurrence of these events including biomolecular
aspects, and to assess the short- and long-term cerebrovascular and global cardiovascular outcome of these patients,
their predictors and infant outcome.
Methods and design: This is an observational, prospective, multicentre, international case–control study. The study
will include patients with cerebrovascular events during pregnancy and/or within six months after delivery. For each
included case, two controls will be prospectively recruited: one pregnant or puerperal subject without any history of
cerebrovascular event and one non-pregnant or non-puerperal subject with a recent cerebrovascular event. All controls
will be matched by age, ethnicity and type of cerebrovascular event with their assigned cases. The pregnant controls
will be matched also by pregnancy weeks/trimester. Follow-up will last 24 months for the mother and 12 months for
the infant.
Summary: To better understand causes and outcomes of uncommon conditions like pregnancy/postpartum-related
cerebrovascular events, the development of multisite, multidisciplinary registry-based studies, such as the Stroke in
Pregnancy and Postpartum study, is needed in order to collect an adequate number of patients, draw reliable conclusions
and give definite recommendations on their manageme