Decompressive craniectomy for massive internal carotid artery infarction after pediatric penetrating neck trauma.
Pediatric penetrating carotid arterial trauma is a rare unreported cause of malignant cerebral infarction. Despite increasing evidence of benefit of decompressive hemicraniectomy (DCH) in pediatric malignant stroke, indications and predictors of outcome remain controversial. We report a 4-year-old boy with penetrating zone II neck trauma with laceration of the right internal carotid artery who developed malignant cerebral infarction requiring DCH. Impressive neurological recovery and excellent functional outcome was observed with good psychomotor development and quality of life. To our knowledge, this is the first reported case of pediatric malignant ICA infarction due to penetrating arterial trauma with good neurologic outcome after DCH.
Department of Neurosurgery, Centro Hospitalar S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. bmfcarvalho@gmail.com.
Bruno Miguel Fernandes
BM
de Carvalho
Department of Neurosurgery, Centro Hospitalar S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. clarachamadoira@gmail.com.
Clara
C
Chamadoira
Department of Neuroradiology, Centro Hospitalar S. João, Porto, Portugal. ritafig7@gmail.com.
Rita
R
Figueiredo
Department of Neurosurgery, Centro Hospitalar S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. josuepereira@sapo.pt.|Neurosciences Department, Hospital CUF Porto, Porto, Portugal. josuepereira@sapo.pt.
Josué
J
Pereira
Department of Pediatric Intensive Care Unit, Centro Hospitalar S. João, Porto, Portugal. luisagaspar@hotmail.com.|Department of Pediatrics, Hospital of Faro - Centro Hospitalar of Algarve EPE, Faro, Portugal. luisagaspar@hotmail.com.
Luísa
L
Gaspar
Department of Neurosurgery, Centro Hospitalar S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. ruimcvaz@gmail.com.|Neurosciences Department, Hospital CUF Porto, Porto, Portugal. ruimcvaz@gmail.com.
Rui
R
Vaz
D020520:Brain Infarction / Q000209:etiology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D002675:Child, Preschool; D056424:Decompressive Craniectomy; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000150:complications / Q000601:surgery*; D014950:Wounds, Penetrating / Q000150:complications / Q000601:surgery*
Children; Decompressive craniectomy; Hemicraniectomy; Malignant cerebral infarction; Pediatric; Stroke