Carotid dissection causing stroke in a 13-year-old boy with mild hyperhomocysteinemia: case report

Area of Science:

• Neurology
• Vascular Medicine
• Biochemistry

Background:

• Carotid dissection is a rare but serious cause of stroke, particularly in younger individuals.
• Hyperhomocysteinemia, an elevation in plasma homocysteine levels, is a known risk factor for vascular diseases.
• The association between carotid dissection and mild hyperhomocysteinemia remains an area of ongoing research.

Observation:

• A 13-year-old Thai male presented with stroke secondary to carotid dissection.
• Mild elevation of plasma total homocysteine (tHcy) was noted in the patient.
• Neurological improvement was observed following anticoagulation therapy.

Findings:

• Plasma tHcy levels decreased after the administration of vitamin supplements.
• The patient achieved a normal neurological state during long-term follow-up.
• This case suggests a potential link between mild hyperhomocysteinemia and the pathogenesis of carotid dissection.

Implications:

• Mild hyperhomocysteinemia may be a contributing factor in the development of carotid dissection.
• Further research is warranted to explore the role of homocysteine in vascular dissections.
• This case highlights the importance of considering metabolic factors in the etiology of stroke in young patients.