[Acute ischemic stroke in female adolescent - Case report]

Area of Science:

• Neurology
• Pediatric Neurology
• Vascular Neurology

Background:

• Cerebral arterial dissection and stroke are rare in adolescents.
• Sudden neurological deficits in young athletes warrant thorough investigation.

Observation:

• A 15-year-old female presented with acute neck pain, collapse, right hemiparesis, and expressive aphasia after soccer practice.
• Initial CT angiography suggested left carotid arterial dissection, but conventional angiography revealed no dissection or thrombus.
• Ischemic changes were noted on CT scan, with decreased perfusion in the left middle cerebral artery.

Findings:

• The clinical presentation and imaging findings were most consistent with reverse cerebral vasoconstriction syndrome (RCVS).
• RCVS is a rare condition characterized by reversible narrowing of cerebral arteries, often presenting with thunderclap headaches or focal neurological deficits.
• This case highlights RCVS as a potential cause of stroke in the pediatric population.

Implications:

• Early recognition and appropriate treatment of RCVS are crucial to prevent recurrent ischemic events.
• Calcium channel inhibitors are a mainstay treatment for RCVS, aiming to restore normal cerebral blood flow.
• This case underscores the importance of considering RCVS in the differential diagnosis of stroke in young individuals, even in the absence of typical risk factors.