RESUMEN
BACKGROUND: Congenital infections are associated with a wide spectrum of clinical symptoms, including lenticulostriate vasculopathy (LSV). OBJECTIVE: To determine the relationship between LSV and congenital infections, as diagnosed by TORCH serology and viral culture for cytomegalovirus (CMV). METHODS: All neonates with LSV admitted to our neonatal intensive-care unit from 2004 to 2008 were included in the study. Results of maternal and neonatal TORCH testing were evaluated. RESULTS: During the study period, cranial ultrasound scans were performed in 2,088 neonates. LSV was detected in 80 (4%) neonates. Maternal and/or neonatal serological TORCH tests were performed in 73% (58/80) of cases. None of the mothers or infants (0 of 58) had positive IgM titres for Toxoplasma, rubella, CMV or herpes simplex virus. Additional urine culture for CMV was performed in 38 neonates. None of the infants (0 of 38) had a positive CMV urine culture test. CONCLUSIONS: Routinely applied efforts to diagnose congenital infections in cases presenting with LSV have a poor yield. Routine TORCH screening in neonates with LSV cases should only be regarded as mandatory once well-designed studies demonstrate a clear diagnostic benefit.
Asunto(s)
Enfermedad Cerebrovascular de los Ganglios Basales/diagnóstico , Tamizaje Neonatal/estadística & datos numéricos , Algoritmos , Enfermedad Cerebrovascular de los Ganglios Basales/congénito , Enfermedad Cerebrovascular de los Ganglios Basales/epidemiología , Infecciones por Citomegalovirus/congénito , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/epidemiología , Pruebas Diagnósticas de Rutina/métodos , Pruebas Diagnósticas de Rutina/estadística & datos numéricos , Ecoencefalografía/estadística & datos numéricos , Femenino , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Masculino , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/estadística & datos numéricos , Madres/estadística & datos numéricos , Tamizaje Neonatal/métodos , Prevalencia , Estudios Retrospectivos , Pruebas Serológicas/métodos , Pruebas Serológicas/estadística & datos numéricosRESUMEN
Fenestration of the cervical segment of the internal carotid artery (ICA) is considered an extremely rare anatomic variant, with, to the best of our knowledge, only four cases reported in the literature. We report six angiographic observations of apparent fenestration of the cervical ICA, which we believe are secondary to arterial dissection. We discuss the angiographic appearance of these pseudofenestrations and their potential clinical implications.