title: Increased cytokine levels in a cerebral mycotic aneurysm in a child with Down's syndrome.
abstract: Cerebral mycotic aneurysms are one of the most serious complications of bacterial endocarditis but the mechanism underlying cerebral aneurysms is unclear. We reported the cytokine levels in a cerebral mycotic aneurysm in a child with Down's syndrome. The patient was a 12-year-old female. She was diagnosed as having Down's syndrome and congenital heart disease consisting of an endocardial cushion defect at birth. She underwent a radical operation at 9 years but mitral valve regurgitation remained. She was hospitalized with high fever, vomiting, loss of activity and gait disturbance. Neurological examination revealed facial palsy and hemiparesis on the left side. Cytokines such as IL-6, TNF-alpha, sTNFR1 and sE-selectin were elevated in blood, and IL-6, TNF-alpha and sTNFR1 in cerebrospinal fluid. T2-weighted MRI disclosed a low intensity area in the right Sylvian sulcus. MR angiography showed an aneurysm of the right middle cerebral artery. We think that cytokines and the formation abnormality of collagen fibers are related to the production of aneurysms.
authors.affiliation: Department of Pediatrics, Tokyo Metropolitan Hachioji Children's Hospital, Hachioji, Tokyo, Japan. ozawa@shimaryo.or.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ozawa
authors.forename: Megumi
authors.initials: M
authors.lastname: Toba
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakamoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Noma
authors.forename: Takashi
authors.initials: T
authors.lastname: Ichiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D002533:Cerebral Angiography; D002648:Child; D016207:Cytokines / Q000097:blood / Q000134:cerebrospinal fluid*; D004314:Down Syndrome / Q000134:cerebrospinal fluid / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000134:cerebrospinal fluid / Q000150:complications*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000134:cerebrospinal fluid* / Q000209:etiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging
chemical_list: D016207:Cytokines