Ischemic stroke complicating pediatric cardiovascular disease.
BACKGROUND
After a year of unsuccessful treatment for hypertension, a young boy underwent a stenting procedure for aortic hypoplasia and awoke with hemiparesis and language deficits.


METHODS
Neuroimaging, echocardiography, craniocervical vascular imaging and prothrombotic testing.


METHODS
Procedure-related acute arterial ischemic stroke and malignant cerebral edema with herniation.


RESULTS
Anticoagulation with heparin, seizure prophylaxis and neuroprotective care, including external cooling for hyperthermia. Medical management of increased intracranial pressure and hemicraniectomy at 48 h for malignant cerebral edema. Treatment of deep vein thrombosis with inferior vena cava filter was also required. Long term treatments included extensive rehabilitation, aspirin, antiepileptics, antidyskinetics, antidepressants, antihypertensives and cosmetic skull reconstruction.
Kirton
Adam
A
Children's Stroke Program, Division of Neurology, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. adam.kirton@sickkids.ca
DeVeber
Gabrielle
G
D000925:Anticoagulants; D001013:Aorta, Thoracic / Q000002:abnormalities*; D001018:Aortic Diseases / Q000150:complications* / Q000151:congenital / Q000175:diagnosis; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006328:Cardiac Catheterization; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007036:Hypothermia, Induced; D018810:Magnetic Resonance Angiography; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants; D018696:Neuroprotective Agents