Carotid Artery Dissection With Associated Territory Stroke After a Minor Head Trauma in a Healthy 4-Month-Old Child.
Internal carotid artery (ICA) dissections with associated stroke are rare events in infants. The usual pathomechanisms include direct trauma to the artery, blunt intraoral trauma, or child abuse. We describe the case of a 4-month-old male patient with ICA dissection and associated middle cerebral artery territory infarction associated with hyperextension/hyperrotation after a minor head injury. Upon treatment with anticoagulants, the patient showed significant improvement of the left-sided hemiparesis. Hemorrhagic transformation that presented shortly after middle cerebral artery infarction did not further increase under heparin treatment and prevented further embolism. In conclusion, hyperextension and/or hyperrotation in minor head trauma is a possible pathomechanism for ICA dissection in infants. However, the scenario is extremely rare, and to our best knowledge, this is the first report describing it. In our patient, anticoagulation did not worsen hemorrhagic transformation.
Robert
R
Zant
Michael
M
Melter
Christian
C
Doerfler
Felix
F
Schlachetzki
Ernst-Michael
EM
Jung
Stefan
S
Schilling
Juergen
J
Kunkel
D000925:Anticoagulants / Q000627:therapeutic use*; D002343:Carotid Artery, Internal / Q000473:pathology; D020215:Carotid Artery, Internal, Dissection / Q000150:complications*; D006259:Craniocerebral Trauma / Q000150:complications*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000150:complications* / Q000188:drug therapy; D017585:Ultrasonography, Doppler, Transcranial
D000925:Anticoagulants