Both occlusive lesions and aneurysms of cerebral arteries have been described as associated with NF1 in occasional patients.
In the occlusive disease of cerebral arteries described by several authors (Tomsick et al. 1976, Taboada et al. 1979, Crawford et al. 1988), the angiographic findings have included occlusion of the supraclinoid internal carotid artery, the proximal anterior cerebral and middle cerebral arteries and, less commonly, the more distal branches of these arteries. Occlusion of the posterior cerebral artery has been reported, although involvement of the posterior circulation is rare. Basal teleangiectasiae producing a moyamoya appearance have been described to be associated with occlusions of the major intracranial vessels.
The occlusive disease of the cerebral arteries in NF has been found most often in children, in whom it has often been associated with cerebral infarction and has not been progressive. The occlusive lesions have been thought to be caused by intimal smooth muscle cell proliferation.
Intracranial aneurysms (Tomsick et al. 1976) and arteriovenous malformations and aneurysms of cervical arteries have been described in patients with NF1 (Deans et al. 1982, Westacott et al. 1988, Schiewinck & Piepgras 1991, Hoffman et al. 1998). These lesions usually manifest in the fifth or sixth decade of life, and they are more common in female than male patients. The vertebral arteries are most commonly affected.
The generalized mesenchymal dysplasia in NF1 may cause structural weakness of the arterial wall and predispose the patient to aneurysm formation. (Deans et al. 1982). Mechanical factors (chiropractic manipulation, etc.) have also been thought to play a role in the formation of vertebral aneurysms. The primary weakness of the arterial wall in NF1 could lead to the development of an arteriovenous fistula through rupture of a preexisting aneurysm or direct rupture of the artery into adjacent veins.
Sorry just thought of this as another potential cause of hamstring stiffness and pain that can be associated with NF, just mentioning it as something to look into if they haven't had a recent look.Spondylolisthesis is a rare disorder that is most often associated with a pathologic luxation of the vertebra because of erosions of the pedicles or pars from foraminal neurofibroma or dural ectasia.
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