title: Traumatic posterior cerebral artery occlusion in a 14-month-old child.
abstract: Following a head injury, a 14-month-old male presented with neck stiffness and 24 hours later developed bilateral lateral rectus palsies. An unenhanced cerebral computed tomographic scan performed on admission revealed evidence of subarachnoid hemorrhage, cerebral edema, and mild-to-moderate compensated supratentorial hydrocephalus. A second scan performed 96 hours after the head injury revealed a mural thrombus at the tip of the basilar artery without any evidence of infarction. A third scan performed 12 days later revealed that the thrombus had resolved. However, a left posterior cerebral artery territory infarct was visualized. We postulate that the thrombus had embolized to the left posterior cerebral artery and caused occlusion of its cortical branch and subsequent infarction. A magnetic resonance angiography performed 20 days later excluded any vascular abnormality. The bilateral lateral rectus palsies persisted at the 6-month follow-up. To our knowledge, a head injury leading to a posterior cerebral artery territory infarct has not been reported earlier in a young child.
authors.affiliation: Division of Pediatric Neurology; Department of Pediatrics; LTM Medical College and LTMG Hospital; Sion; Bombay 400 022, India.
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Kelkar
authors.forename: Sunil
authors.initials: S
authors.lastname: Karande
authors.forename: Vikram
authors.initials: V
authors.lastname: Chaudhary
authors.forename: Madhuri V
authors.initials: MV
authors.lastname: Kulkarni
mesh_terms: D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D001930:Brain Injuries / Q000150:complications*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging; D008297:Male; D011596:Psychomotor Disorders / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed