title: Blunt Intraoral Trauma Resulting in Internal Carotid Artery Dissection and Infarction in a Child.
abstract: A 16-month-old child fell forward onto her toothbrush sustaining minor oropharyngeal injury. The following day, she became acutely lethargic with localizing neurologic signs of a cerebrovascular infarct. CTA and MR imaging demonstrated occlusion of the right internal carotid artery with a large right middle cerebral artery territory infarction. She was treated with decompressive craniectomy and anticoagulation but remained weak on the left side. Pediatric oropharyngeal injuries can rarely be complicated by internal carotid artery injury with dissection, thrombosis, or embolization to the cerebral circulation. For the best outcome, carotid dissection treatment requires prompt diagnosis at the initial onset of neurologic symptoms. However, further research is needed to determine the best management and advanced imaging work-up for neurologically intact children.
authors.affiliation: From the *Departments of Radiology and †Pediatrics, University of California Davis, Sacramento, CA.
authors.forename: Chris
authors.initials: C
authors.lastname: Bent
authors.forename: Peter
authors.initials: P
authors.lastname: Shen
authors.forename: Brian
authors.initials: B
authors.lastname: Dahlin
authors.forename: Kevin
authors.initials: K
authors.lastname: Coulter
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D056424:Decompressive Craniectomy; D005260:Female; D006801:Humans; D007223:Infant; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D009960:Oropharynx / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis
chemical_list: D000925:Anticoagulants