Spontaneous extracranial carotid artery dissection in children.
Dissection of cerebral arteries as a cause of stroke is rarely recognized in children. Two patients with stroke due to extracranial carotid artery dissection are reported. A 7-year-old girl with a 2-week history of right arm chorea had a left basal ganglia infarct and is receiving haloperidol for persistent chorea. The second patient, a 15-year-old boy, developed aphasia and right hemiparesis a day before admission during a football game without obvious trauma. He had a large left middle cerebral artery infarct and died of cerebral edema and herniation. We believe that strokes due to arterial dissection are more common than currently recognized, partly because of a lack of history of trauma, and suggest that cerebral artery dissection be considered as an etiology of childhood strokes. Greater awareness of arterial dissection as a cause of stroke and availability of noninvasive techniques like magnetic resonance angiography should result in a more accurate diagnosis and improved prognosis in these patients.
Patel
H
H
Department of Neurology, Indiana University School of Medicine, Indianapolis, USA.
Smith
R R
RR
Garg
B P
BP
D000293:Adolescent; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis*; D001479:Basal Ganglia / Q000098:blood supply; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology; D002648:Child; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008297:Male; D009460:Neurologic Examination