Document Detail

Cerebral small vessel diseases: manifestations in young women.
MedLine Citation:
PMID:  16415678     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Cerebral small vessel diseases are responsible for 20-30% of ischemic strokes as well as for a considerable proportion of cerebral hemorrhages and encephalopathies. Less known than the manifestations in old age are those in young women comprising posterior encephalopathy and Susac's syndrome.
RECENT FINDINGS: Magnetic resonance imaging has allowed us to identify posterior encephalopathy, characterized by headache, seizures, visual disturbances and hypertension, as a frequent complication of preeclampsia/eclampsia syndrome in the perinatal and postpartum period. Magnetic resonance findings are pathognomonic with bilateral cortical-subcortical lesions in the posterior hemispheres typically sparing the calcarine fissure. Conversely, white matter lesions on magnetic resonance imaging particularly involving the corpus callosum, and a (subclinical) sensorineural hearing loss are diagnostic of the retinocochleocerebral vasculopathy called Susac's syndrome.
SUMMARY: Posterior encephalopathy can also follow from a broad spectrum of endotheliotoxic conditions like chemotherapy, immunosuppression and sepsis. Early recognition of the disorder is decisive for a benign outcome since therapy consists of removal of precipitating factors, lowering of blood pressure and treatment with magnesium sulfate. The retinocochleocerebral vasculopathy appears to be underdiagnosed. An autoimmune-mediated arteriolopathy is presumed and the disease is nearly always monophasic. A variety of therapeutic approaches have been recommended, none of which, however, is based on anything other than anecdotal evidence.
E Bernd Ringelstein; Stefan Knecht
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in neurology     Volume:  19     ISSN:  1350-7540     ISO Abbreviation:  Curr. Opin. Neurol.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-17     Completed Date:  2006-04-28     Revised Date:  2013-01-18    
Medline Journal Info:
Nlm Unique ID:  9319162     Medline TA:  Curr Opin Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  55-62     Citation Subset:  IM    
Department of Neurology, University Hospital Münster, Münster, Germany.
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MeSH Terms
Brain Infarction / diagnosis*,  etiology,  physiopathology
Eclampsia / physiopathology*
Hearing Loss, Sensorineural / etiology,  pathology,  physiopathology
Hypoxia-Ischemia, Brain / etiology,  pathology,  physiopathology
Microcirculation / pathology,  physiopathology
Occipital Lobe / blood supply,  pathology,  physiopathology
Posterior Cerebral Artery / pathology,  physiopathology*
Retinal Diseases / etiology,  pathology,  physiopathology
Vertebrobasilar Insufficiency / etiology,  pathology,  physiopathology*

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