title: Backward somersault as a cause of childhood stroke: a case report of isolated middle cerebral artery dissection in an adolescent boy.
abstract: Arterial dissection is a rare but serious cause of acute childhood stroke. Here, we present the case of a 15-year-old adolescent boy, an art school student, who suddenly experienced left hemi-paralysis after performing repeated backward somersaults, diagnosed as right-sided middle cerebral artery (MCA) hyperacute infarct due to isolated MCA dissection. Middle cerebral artery dissection in childhood is rare, as in our patient; however, pediatricians and emergency physicians should take MCA dissection into consideration in the differential diagnosis when hyperdense MCA sign is detected from unenhanced cranial computed tomography (CT) of childhood and/or adolescent stroke, with a special history such as backward somersault as in this case. Besides, unenhanced cranial CT and further imaging studies, including CT angiography and magnetic resonance imaging, provide a crucial role in early diagnosis to design proper treatment of acute childhood stroke in the ED.
authors.affiliation: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Neihu 114, Taipei, Taiwan, Republic of China.
authors.forename: Ko-Chiang
authors.initials: KC
authors.lastname: Hsu
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Kao
authors.forename: Shyi-Jou
authors.initials: SJ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000784:Aortic Dissection / Q000209:etiology*; D006173:Gymnastics / Q000293:injuries*; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology*; D008297:Male; D010243:Paralysis / Q000209:etiology*; D011998:Recreation; D020521:Stroke / Q000209:etiology*