Neurofibromatosis, stroke and basilar impression: case report

Arquivos de Neuro-Psiquiatria

Elcio Juliato Piovesan²  Rosana Herminia Scola²  Lineu Cesar Werneck²  Viviane H. Flumignan ZÉtola²  Edison Matos NÓvak²  Fabio Massaiti Iwamoto¹  Liciane Maia Piovesan¹ 

[1] ,Federal University of Parana Hospital de Clinicas Internal Medicine Department

关键词: basilar impression;    moyamoya syndrome;    neurofibromatosis;    stroke;    impressão basilar;    síndrome de moyamoya;    neurofibromatose;    acidente vascular cerebral;   

DOI  :  10.1590/S0004-282X1999000300022

来源: SciELO

【 摘 要 】

Neurofibromatosis type 1 (NF1) can virtually affect any organ, presenting most frequently with "cafe au lait" spots and neurofibromas. Vasculopathy is a known complication of NF1, but cerebrovascular disease is rare. We report the case of a 51-year-old man admitted to the hospital with a history of stroke four months before admission. On physical examination, he presented various "cafe au lait" spots and cutaneous neurofibromas. Neurologic examination demonstrated right-sided facial paralysis, right-sided hemiplegia, and aphasia. Computed tomography scan of head showed hypodense areas in the basal ganglia and centrum semiovale. Radiographs of cranium and cervical spine showed basilar impression. Angiography revealed complete occlusion of both vertebral and left internal carotid arteries, and partial stenosis of the right internal carotid artery. A large network of collateral vessels was present (moyamoya syndrome). It is an uncommon case of occlusive cerebrovascular disease associated with NF1, since most cases described in the literature are in young people, and tend to spare the posterior cerebral circulation. Basilar impression associated with this case may be considered a pure coincidence, but rare cases of basilar impression and NF1 have been described.

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