Acute Stroke in Middle Cerebellar Peduncle in a Patient With FXTAS.

Front Genet

Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States.

Published: May 2018

AI Article Synopsis

  • Fragile-X associated tremor/ataxia syndrome (FXTAS) typically shows T2 hyperintensity in the middle cerebellar peduncles on MRI, but this case reports a rare ischemic stroke in the same area.
  • A 61-year-old man with FXTAS experienced worsening balance and nausea after chiropractic neck manipulation; he was found to have an acute infarct in the left middle cerebellar peduncle.
  • The stroke was likely caused by a combination of FXTAS neurodegeneration, small vessel disease, and the effects of neck manipulation, leading to damage in the brain's Purkinje cells.

Article Abstract

Fragile-X associated tremor/ataxia syndrome (FXTAS) is commonly associated with T2 hyperintensity in the middle cerebellar peduncles (MCP) on magnetic resonance imaging (MRI). However, ischemic stroke in the MCP in a patient with FXTAS has not previously been described. A 61-year-old man with hypertension, sleep apnea, obesity, and FXTAS presented to the emergency department with 2 days of worsening balance and nausea which began 2 days after chiropractic neck manipulation. Examination revealed new nystagmus and worsening dysmetria. Workup revealed an acute infarct in the left MCP, atherosclerotic narrowing of the V4 segment of the left vertebral artery, inadequately controlled hypertension, and a LDL of 127. Isolated MCP infarcts are rare and typically associated with hypoperfusion in the setting of vertebral artery disease and neck manipulation. We suspect that underlying neurodegeneration due to FXTAS with superimposed small vessel disease and neck manipulation may have caused preferential damage to the Purkinje cells in the MCP.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983052PMC
http://dx.doi.org/10.3389/fgene.2018.00187DOI Listing

Publication Analysis

Top Keywords

neck manipulation
12
middle cerebellar
8
patient fxtas
8
vertebral artery
8
disease neck
8
fxtas
5
mcp
5
acute stroke
4
stroke middle
4
cerebellar peduncle
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!