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Internal Carotid Dissection as the Cause of Stroke in Childhood
Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs' risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with invo...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261171/ https://www.ncbi.nlm.nih.gov/pubmed/34258095 http://dx.doi.org/10.1155/2021/5568827 |
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author | Cinelli, Giulia Loizzo, Vitaliana Montanari, Lisa Filareto, Ilaria Caramaschi, Elisa Predieri, Barbara Iughetti, Lorenzo |
author_facet | Cinelli, Giulia Loizzo, Vitaliana Montanari, Lisa Filareto, Ilaria Caramaschi, Elisa Predieri, Barbara Iughetti, Lorenzo |
author_sort | Cinelli, Giulia |
collection | PubMed |
description | Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs' risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with involuntary hypertonic closure of the right hand associated with transient difficulty for both fine movements of the right arm and speech. She had a history of minor cervical trauma occurring 20 days prior to our observation without other associated risk factors. Magnetic resonance imaging and magnetic resonance angiography showed ischemic lesions due to the left ICA dissection. Treatment with both acetylsalicylic acid and levetiracetam allowed recanalization of the ICA associated with the resolution of clinical signs. Our clinical case suggests that the ICA dissection must be suspected early whenever a child manifests mild neurologic deficits after a cervical trauma, especially if they are associated with headache and/or cervical pain. Moreover, the management of ICA dissection must be improved. |
format | Online Article Text |
id | pubmed-8261171 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-82611712021-07-12 Internal Carotid Dissection as the Cause of Stroke in Childhood Cinelli, Giulia Loizzo, Vitaliana Montanari, Lisa Filareto, Ilaria Caramaschi, Elisa Predieri, Barbara Iughetti, Lorenzo Case Rep Pediatr Case Report Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs' risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with involuntary hypertonic closure of the right hand associated with transient difficulty for both fine movements of the right arm and speech. She had a history of minor cervical trauma occurring 20 days prior to our observation without other associated risk factors. Magnetic resonance imaging and magnetic resonance angiography showed ischemic lesions due to the left ICA dissection. Treatment with both acetylsalicylic acid and levetiracetam allowed recanalization of the ICA associated with the resolution of clinical signs. Our clinical case suggests that the ICA dissection must be suspected early whenever a child manifests mild neurologic deficits after a cervical trauma, especially if they are associated with headache and/or cervical pain. Moreover, the management of ICA dissection must be improved. Hindawi 2021-06-28 /pmc/articles/PMC8261171/ /pubmed/34258095 http://dx.doi.org/10.1155/2021/5568827 Text en Copyright © 2021 Giulia Cinelli et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Cinelli, Giulia Loizzo, Vitaliana Montanari, Lisa Filareto, Ilaria Caramaschi, Elisa Predieri, Barbara Iughetti, Lorenzo Internal Carotid Dissection as the Cause of Stroke in Childhood |
title | Internal Carotid Dissection as the Cause of Stroke in Childhood |
title_full | Internal Carotid Dissection as the Cause of Stroke in Childhood |
title_fullStr | Internal Carotid Dissection as the Cause of Stroke in Childhood |
title_full_unstemmed | Internal Carotid Dissection as the Cause of Stroke in Childhood |
title_short | Internal Carotid Dissection as the Cause of Stroke in Childhood |
title_sort | internal carotid dissection as the cause of stroke in childhood |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261171/ https://www.ncbi.nlm.nih.gov/pubmed/34258095 http://dx.doi.org/10.1155/2021/5568827 |
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