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Published on: August 11, 2023
Traumatic Vertebral Artery Dissection and Basilar Artery Occlusion/Stroke in a 7-Year-Old Child: A Case Report
1Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, United States.
Insights
Vertebral artery dissection (VAD) in a child led to basilar artery occlusion/stroke (BAO/BAS). Prompt heparin treatment improved neurological symptoms, highlighting early intervention importance in pediatric VAD.
Area of Science:
- Neurology
- Pediatric Medicine
- Vascular Surgery
Background:
- Vertebral artery dissection (VAD) is a rare cause of stroke in children.
- VAD can lead to basilar artery occlusion/stroke (BAO/BAS), a critical condition.
- Pediatric VAD cases require prompt diagnosis and management to prevent severe outcomes.
Observation:
- A 7-year-old boy presented with left-sided weakness and facial droop after a fall.
- Initial symptoms included altered sensorium, followed by focal neurological deficits.
- Imaging confirmed left VAD with left posterior inferior cerebellum and right pons ischemia.
Findings:
- Computed tomography angiogram revealed left vertebral artery dissection and basilar artery thrombosis.
- The patient received 96 hours of heparinization followed by 6 months of low-molecular-weight heparin.
- Neurological symptoms significantly improved following anticoagulation therapy.
Implications:
- This case highlights the possibility of VAD leading to BAO/BAS in pediatric trauma.
- Early anticoagulation therapy appears effective in managing VAD-induced BAO/BAS in children.
- Further research into pediatric VAD management protocols is warranted.
Abstract:
Vertebral artery dissection (VAD) followed by basilar artery occlusion/stroke (BAO/BAS) is a rare but potentially life-threatening complication. We present a case report of a 7-year-old boy with VAD complicated by BAO/BAS 4 days after falling off a scooter. Symptoms included left-sided weakness and facial droop preceded by a 20-minute episode of altered sensorium. Magnetic resonance imaging showed ischemic changes in the left posterior inferior cerebellum and right pons. Computed tomography angiogram confirmed dissection of the left vertebral artery with occlusion/thrombosis of the basilar artery. Heparinization for 96 hours, followed by 6 months of low-molecular weight heparin injection, resulted in improvement of his neurological symptoms.
