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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
18:50

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[Cerebral artery infarction presented as an unusual complication of acute middle otitis]

Luis Rafael Moscote-Salazar1, Gabriel Alcalá-Cerra, Sandra Milena Castellar-Leones

  • 1Universidad de Cartagena, Cartagena de Indias, Columbia. mineurocirujano@aol.com

Revista Medica Del Instituto Mexicano Del Seguro Social
|September 12, 2013
PubMed

Insights

Acute otitis media can lead to rare but severe cerebral artery infarction in children. This case highlights the poor prognosis despite advances, emphasizing the need for prompt recognition of neurological signs.

Area of Science:

  • Pediatric neurology
  • Infectious diseases
  • Vascular neurology

Background:

  • Acute otitis media is common in children.
  • Intracranial complications like meningitis occur in ~2% of cases.
  • Cerebral infarction typically involves the venous system, but arterial involvement is rare.

Observation:

  • A 12-month-old girl presented with fever, confusion, and neurological deficits (anisocoria, mydriasis, hemiparesis).
  • Computed tomography revealed extensive cerebral artery infarction.
  • Parents declined surgical intervention, leading to the patient's death within 48 hours.

Findings:

  • Cerebral artery infarction secondary to acute otitis media is a rare but devastating complication.
  • Neurological deterioration despite antimicrobial therapy suggests treatment ineffectiveness.
  • The clinical prognosis remains poor, even with modern medical advancements.

Implications:

  • Clinicians should maintain a high index of suspicion for cerebral infarction in children with acute otitis media and neurological symptoms.
  • Prompt diagnosis and aggressive management are crucial, though outcomes can be poor.
  • This case underscores the critical link between otitis media and cerebrovascular events in pediatrics.
Abstract

Keywords:
arteria cerebral mediacerebral infarctioncerebrovascular disordersinfarto cerebralmiddle cerebral arteryotitis mediatrastornos cerebrovasculares

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