Transient Quadriparesis due to Dysgenesis of the Posterior Arch of the Atlas: Case Report

Acase of 14-year-old student is presented with the complaint of recurrent attack of transient quadriparesis during hyperextension of the neck. On 3-dimensional spinal CT and MRI, the authors confirmed intrusion of posterior tubercle of the atlas with increased signal on T1- and T2- weighted image was found. The clinical manifestations were improved without having cervical instability after a posterior laminectomy of the atlas.

Cerebrovascular Disease during Pregnancy

Cerebrovascular lesions during pregnancy, although uncommon, account for a significant number of maternal deaths. Maternal mortality related to stroke is usually associated with eclampsia complicated by cerebral edema or intracerebral hemorrhage. At times, hypertensive intracerebral hemorrhage, cerebral arteriovenous malformation, and moyamoya disease may also be related. Nine patients with cerebrovascular disease during pregnancy were reviewed. The mean age of pregnancy related hypertensive intracerebral hemorrhage was 32.1+/-6.6years and the time of attack was intrauterine pregnancy(IUP) 27.2+/-13.8 weeks. The basal ganglia hemorrhage was noted in 55.5%(5 ca-ses), followed by intraventricular hemorrhage(IVH)(4 cases) and subcortical hemorrhage(3 cases). The pregnancy related hypertensive intracerebral hemorrhage was developed more often in multigravida(6 out of 9) than in priemiparous woman. Good outcome was expected in patients with subcortical location(p=0.058), primigravida(p=0.058), and high initial GCS score(p=0.056).