title: Misplaced peripherally inserted central catheter: an unusual cause of stroke.
abstract: Stroke in pediatric patients occurs with a frequency of 3 to 8 per 100,000. The postevent evaluation attempts to identify the etiology of ischemia whether anatomic, hematologic, or embolic, with the intention of preventing future events. We present the case of a previously healthy male who developed unilateral facial and extremity weakness 2 weeks after receiving an appendectomy. Once the usual etiologies of stroke in pediatric patients were excluded, an evaluation of the peripheral venous catheter (placed for postoperative antibiotic delivery) demonstrated arterial misplacement. This article presents the first reported case of such an occurrence in the literature and exhibits the need to pursue all avenues of evaluation if the etiology of a pediatric stroke is not initially identified.
authors.affiliation: Department of Child Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Sumit
authors.initials: S
authors.lastname: Parikh
authors.forename: Vinodh
authors.initials: V
authors.lastname: Narayanan
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery*; D020144:Basal Ganglia Cerebrovascular Disease / Q000175:diagnosis / Q000209:etiology*; D001916:Brachial Artery / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D038524:Diffusion Magnetic Resonance Imaging; D005548:Foreign-Body Migration / Q000150:complications* / Q000175:diagnosis; D018718:Home Infusion Therapy / Q000295:instrumentation*; D006801:Humans; D020772:Internal Capsule / Q000098:blood supply* / Q000473:pathology; D008297:Male; D019300:Medical Errors; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D013348:Subclavian Artery / Q000473:pathology; D018608:Ultrasonography, Doppler
chemical_list: D000900:Anti-Bacterial Agents