Brain Stem Hemorrhage in a 2-Year-10-Month-Old Child with Renovascular Hypertension Related to Fibromuscular Dysplasia.
Renovascular hypertension due to fibromuscular dysplasia is an uncommon but important cause of pediatric hypertension. It is usually ignored and diagnosed after a long delay because blood pressure is infrequently measured in children. We report a case of previously undiagnosed renovascular hypertension complicated with right renal infarction in a 2-year-10-month-old child, who initially presented as a case of conscious disturbance. The patient's brain CT displayed brain stem hemorrhage, and a brain MRI showed acute hemorrhage and multiple old intracerebral hemorrhage. Therefore, intimal fibromuscular dysplasia of the right renal artery was diagnosed by computed tomography and confirmed after renal angiography. Her blood pressure was gradually normalized after medical therapy, including use of Losartan. She is presently asymptomatic on OPD follow-up. The importance of BP measurement can not be overemphasized in pediatric patients less than three years of age with underlying diseases.


BACKGROUND
Conscious disturbance; Fibromuscular dysplasia; Renovascular hypertension.
Department of Emergency Medicine; ; National Yang-Ming University, Taipei;
Yao-Min
YM
Hung
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung; ; National Yang-Ming University, Taipei; ; Shu-Zen College of Medicine and Management;
Ken-Pen
KP
Weng
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung;
Chu-Chuan
CC
Lin
Department of Radiology, Kaohsiung Veterans General Hospital;
Jer-Shyung
JS
Huang
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung;
Yee-Hsuan
YH
Chiou
Department of Pediatrics, Kaohsiung Chang Gang Memorial Hospital, Kaohsiung, Taiwan.
Kai-Sheng
KS
Hsieh