Isolated midbrain ischemic infarct in association with hyperlipoproteinemia (a): a report of 2 adolescent patients.
Arterial ischemic strokes (AIS) localized solely to the midbrain are extremely uncommon in the pediatric population. Elevated lipoprotein (a), which promotes atherosclerosis and a prothrombotic state, has been associated with increased risk of AIS in children and adults. Here we describe a 17-year-old boy and a 15-year-old girl who presented with internuclear ophthalmoplegia secondary to an isolated midbrain AIS. Evaluation for risk factors for AIS in these otherwise healthy adolescents identified hyperlipoproteinemia (a) in combination with other potential prothrombotic conditions suggesting that hypercoagulable states such as hyperlipoproteinemia (a) may have contributed to development of small-vessel arteriopathy and localized AIS.
Departments of *Hematology †Neurology ‡Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.
Srivandana
S
Akshintala
Robert A
RA
Avery
Jonathan
J
Murnick
Nicole
N
Verdun
Yaser
Y
Diab
D000293:Adolescent; D002544:Cerebral Infarction / Q000097:blood*; D005260:Female; D006801:Humans; D006951:Hyperlipoproteinemias / Q000209:etiology*; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D018455:Protein S Deficiency / Q000209:etiology
D017270:Lipoprotein(a)