- 作者：Femke Maingay-de Groof ; Maarten H. Lequin ; Daniella W. Roofthooft ; Arnold P. Oranje ; Irenaeus F. de Coo ; Levinus A. Bok ; Peter J. van der Spek ; Grazia M. Mancini ; Paul P. Govaert
- 关键词：Incontinentia pigmenti ; Neonate ; Stroke ; NEMO ; Vasculitis
- 刊名：European Journal of Paediatric Neurology
- 出版年：2008
- 出版时间：July 2008
- 年：2008
- 卷：12
- 期：4
- 页码：284-289
- 全文大小：562 K
IntroductionIncontinentia pigmenti (IP) is a rare X-linked dominant neuroectodermal multisystem disorder characterized by skin lesions following Blaschko lines. In almost all patients the skin is involved and in 30–50 % the central nervous system (CNS) is. Vascular occlusive phenomena probably play a role in CNS involvement. Whether these vascular changes are based on macro- or microvascular disease in the neonatal presentation is not fully understood.Patients and methods
We describe two patients with IP with neonatal seizures related to cerebral infarction. In comparison, we reviewed reports of ischaemic cerebrovascular injury in neonatal IP.
Results
No descriptions of documented large artery occlusion in neonatal IP was found in the literature. One of our patients showed striatal arteriopathy, never described before in IP. Extensive injury in one of our cases was heterogeneous, mixing healthy with diseased areas within large arterial fields.
Conclusions
We postulate that neonatal cerebral infarction in IP is a macrovascular disorder of medium sized or small arteries. The pattern of arterial involvement might follow hypothetical brain Blaschko lines. The extent of cerebral involvement probably results from genetic mosaicism in which Lyonisation leads to endothelial apoptosis, similar to the process in the skin.