[Antenatal cerebral artery occlusions (4 new cases)]

Area of Science:

• Neurology
• Obstetrics
• Pathology

Background:

• Cerebral arterial occlusion is a known complication in monozygotic twin pregnancies, particularly when one twin is stillborn.
• Etiologies often cited include embolization from the deceased fetus or disseminated intravascular coagulation leading to emboli in the surviving twin via placental connections.

Observation:

• Some evidence suggests infectious endarteritis as a potential cause, supported by angiographic and histological findings.
• Clinical manifestations may be delayed, appearing weeks after birth.
• Computed tomography (CT) scan and pathological findings are contingent on the timing of the arterial occlusion.

Findings:

• The study describes four recent cases, two involving monozygotic twin pregnancies.
• Pathological, CT scan, and clinical features are analyzed in detail.
• The pathogenesis is discussed in the context of existing literature.

Implications:

• Understanding the timing and etiology of cerebral arterial occlusion is crucial for diagnosis and management in surviving twins.
• Further research into infectious causes may refine diagnostic and therapeutic strategies.
• This condition highlights the complex interplay between fetal development, placental vasculature, and neurological outcomes in twin gestations.