Altered Mental Status in a Child With an Unwitnessed Fall: A Case Report

Area of Science:

• Pediatric Neurology
• Pediatric Cardiology
• Pediatric Pathology

Background:

• Altered mental status in children can stem from various causes, including neurological and systemic conditions.
• Head trauma is a common initial consideration for altered mental status in pediatric patients.
• Embolic strokes, though less common, must be considered in the differential diagnosis.

Observation:

• A 5-year-old boy presented with altered mental status after presumed head trauma, with initial normal computed tomography head findings.
• The patient returned with persistent altered mental status, prompting further investigation.
• Magnetic resonance imaging (MR) of the brain revealed findings suggestive of embolic strokes.

Findings:

• An echocardiogram identified a large atrial mass.
• Pathological examination confirmed the atrial mass to be an atrial myxoma.
• This represents a rare and previously unreported presentation of atrial myxoma in a pediatric patient.

Implications:

• This case underscores the importance of considering cardiac etiologies, such as atrial myxoma, in pediatric patients presenting with stroke-like symptoms.
• Early diagnosis and management of pediatric atrial myxoma are crucial to prevent embolic events.
• Further research into the unique presentations of rare pediatric cardiac tumors is warranted.