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[Ischemic stroke in childhood. A complication of tonsillectomy]
A Matilla Álvarez1, E García Serrano2, T González de la Huebra Labrador3
1Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitario de Salamanca, Salamanca, España.
Insights
A 3-year-old boy experienced an ischemic stroke following a tonsillectomy. This rare complication, diagnosed post-surgery, involved an intraluminal clot in the carotid artery, likely from surgical injury during hemostasis.
Area of Science:
- Pediatric Otolaryngology
- Neurology
- Vascular Surgery
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Postoperative complications can be immediate or delayed.
- Vascular complications, though rare, are a concern.
Observation:
- A 3-year-old boy developed an ischemic stroke diagnosed in the immediate postoperative period after tonsillectomy.
- Diagnostic imaging, including brain echo-doppler and angio-CT, revealed an intraluminal clot in the left internal carotid artery.
Findings:
- The ischemic stroke was attributed to an intraluminal clot in the left internal carotid artery.
- The clot formation is suspected to be a direct result of arterial injury during the surgical ligature for hemostasis.
Implications:
- This case highlights a rare but serious neurological complication following tonsillectomy.
- It underscores the importance of careful surgical technique and awareness of potential vascular complications in pediatric tonsillectomy.
- Further investigation into the mechanisms of vascular injury during tonsillectomy may be warranted.
Abstract:
Tonsillectomy is one of the most frequently performed otorhinolaryngological procedures on children. The postoperative complications are classified into primary or intermediate, which generally appear within 24h, and as secondary or delayed, after 48 h. We present the case of an ischemic stroke after performing a tonsillectomy on a 3 year-old boy, which was diagnosed in the immediate postoperative period. Using brain echo-doppler and angio-CT, an intraluminal clot was observed in the left internal carotid artery, probably as a result of direct vessel injury during arterial ligature for hemostasis.
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