Ischemic infarct in childhood secondary to internal carotid artery dissection. Report of a case

A previously healthy 6-year-old boy, suddenly developed a complete right hemiparesis and dysarthria while playing at school without any history of trauma. All laboratory examinations were normal except for CT brain scan that revealed a small ischemic infarct in the left middle cerebral artery territory. Four vessel cerebral angiography demonstrated a left internal carotid artery dissective obstruction while filling of the right or left vertebral artery resulted in the simultaneous retrograde appearance of the respective middle cerebral artery possibly via the posterior communicating artery. In contrast to the literature data, the patient showed a significant recovery with conservative treatment. This uncommon stroke type in children and the possible protective role of the posterior communicating artery's collateral are further discussed.