[Cerebral ischemic disorders in the young subject. Etiologic diagnostic approach to ischemic disorders].
EXHAUSTIVE WORK-UP: Initial explorations include standard laboratory tests, electrocardiogram, ultrasound exam of the cervical vessels, and transthoracic echocardiogram. If the initial work-up is normal, a transesophageal echocardiogram and/or an angiogram (arteriography, magnetic resonance angiography or spiral CT) can be helpful in addition to further immunology and hemostasis explorations. TRANSESOPHAGEAL ECHOCARDIOGRAM: This is a cardinal exam for the etiological work-up in young subjects having suffered a cerebral ischemic event. It can detect anomalies involving the left atrium and auricle, the interventricular septum or the aortic arch missed on standard echocardiography. CONVENTIONAL ARTERIOGRAPHY: There is a trend to replace conventional arteriography with less invasive techniques such as magnetic resonance angiography or spiral CT. When coupled with an ultrasound exploration of the cervical and intracranial vessels, the contribution of these new techniques is similar to that of conventional arteriography, particularly in patients with arterial disease.
Neau
J P
JP
Clinique Neurologique, Hôpital Jean Bernard, CHU La Milétrie, Poitiers.
Bailbe
M
M
Gil
R
R
D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D003663:Decision Trees; D006801:Humans; D011859:Radiography; D014463:Ultrasonography
Accidents ischémiques cérébraux du sujet jeune. Démarche étiologique en cas d'accidents ischémiques.