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Published on: May 6, 2021
Acute stroke in the burn patient.
Yen-Hsun Lee1, Chung-Lin Chen, Shin-Chen Pan
1Division of Plastic Surgery, Department of Surgery, School of Medicine, National Cheng Kung University, Tainan, Taiwan ROC.
Summary
A severe burn injury in a child led to a stroke caused by carotid artery dissection. This rare complication can occur even after the initial burn recovery phase.
Area of Science:
- Pediatric Medicine
- Neurology
- Burn Injury Management
Background:
- Severe burn injuries in children require extensive medical intervention.
- Post-burn complications can manifest weeks or months after the initial injury.
- Cerebral vascular events are a rare but serious concern in pediatric burn patients.
Observation:
- A 3-year-old boy with a 62% total body surface area burn developed acute right-sided hemiparesis 7 days post-discharge.
- Imaging revealed a left middle cerebral artery territory infarction.
- Magnetic resonance angiography showed nonvisualization and thickened walls of the left distal intracranial carotid and proximal middle cerebral arteries, indicating acute dissection.
Findings:
- Follow-up imaging 10 years later confirmed persistently thickened arterial walls, consistent with old dissection.
- The patient's stroke was attributed to carotid artery dissection secondary to the burn injury.
- This case highlights a delayed neurological complication in pediatric burn survivors.
Implications:
- Carotid artery dissection should be considered in the differential diagnosis of acute stroke in pediatric burn patients.
- Neurological monitoring may be warranted during the recovery phase of severe burn injuries.
- Understanding rare vascular complications is crucial for comprehensive pediatric burn care and long-term outcomes.
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