Symptomatic Brain Hemorrhages from Cavernous Angioma After Botulinum Toxin Infections a Role of TLR/MEKK3 Mechanism? Case Report and Review of the Literature



: Koskimaki J, Zhang DD, Carrion-Penagos J, Girard R, Piedad K, Polster SP, Lyne S, Stadnik A, Awad IA

Publisher: ELSEVIER SCIENCE INC

: 2020

: World Neurosurgery

: WORLD NEUROSURGERY

: WORLD NEUROSURG

: 136

: 7

: 11

: 5

: 1878-8750

DOI: https://doi.org/10.1016/j.wneu.2019.12.172


BACKGROUND: Cavernous angiomas (CAs) are vascular malformations that may result in stroke.CASE DESCRIPTION: Herein, we evaluate a CA patient with chronic migraine who experienced 2 documented symptomatic hemorrhages after receiving respective high doses of botulinum toxin (Btx).CONCLUSIONS: Recently, bacterial lipopolysaccharide has been reported to contribute to CA development through Toll-like receptor signaling, causing hemorrhagic angiogenic proliferation. Lipopolysaccharide and Btx share a common intracellular signaling pathway driving CA development and hemorrhage. Significance of these observations is demonstrated by previous works on plasma molecules showing prognostic associations with symptomatic hemorrhages in human CA, related to the same canonical pathways. Authors suggest careful tracking of the association of Btx and hemorrhage in CA patients.



Last updated on 2024-26-11 at 11:51