Document Detail

Vulnerability of the infant brain stem to ischemia: a possible cause of sudden infant death syndrome.
MedLine Citation:
PMID:  8734017     Owner:  NLM     Status:  MEDLINE    
In infants, extreme extension or rotation of the head can occlude one or both vertebral arteries. We sought to determine whether small communicating arteries or asymmetric vertebral arteries could predispose the brain stem to ischemia should such head movements occur. In 68 infants, the carotid, posterior communicating, precommunicator posterior cerebral, basilar and vertebral arteries were fixed in formalin, embedded in resin, the circumferences measured by image analysis, and the relative conductance of blood in each artery per gram of brain calculated. Conductance in the vertebrobasilar and carotid systems lagged behind increases in brain weight during the postnatal growth spurt. In 81% of infants, conductance through the communicating arteries was less than 25% of basilar artery conductance. Conductance in one vertebral artery was less than half that of the contralateral artery in 41% of infants. In conclusion, the lag in available blood flow and small communicating and asymmetric vertebral arteries may predispose the infant brain stem to ischemia if one or both vertebral arteries are occluded by head rotation or extension. Because these head movements are likely to be accentuated in the prone sleeping position (a risk factor for sudden infant death syndrome), we suggest that vertebral artery occlusion may underlie some cases of sudden unexpected infant death.
R Pamphlett; N Murray
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of child neurology     Volume:  11     ISSN:  0883-0738     ISO Abbreviation:  J. Child Neurol.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-10-31     Completed Date:  1996-10-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8606714     Medline TA:  J Child Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  181-4     Citation Subset:  IM    
Department of Pathology (Neuropathology Division), University of Sydney, Australia.
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MeSH Terms
Age Factors
Arterial Occlusive Diseases / physiopathology
Basilar Artery / physiopathology
Brain Ischemia / etiology*,  pathology
Brain Stem / blood supply*
Carotid Arteries / physiopathology
Cerebrovascular Circulation
Linear Models
Sudden Infant Death / etiology
Vertebral Artery / physiopathology
Vertebrobasilar Insufficiency / complications,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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