Pediatric internal carotid artery dissection and stroke after minor head injury

Area of Science:

• Neurology
• Pediatric Stroke
• Neurovascular Imaging

Background:

• Pediatric arterial ischemic stroke (AIS) is a significant cause of acquired brain injury in children.
• Current management guidelines for childhood stroke are not well-established.
• Cerebral arteriopathies are common causes of pediatric AIS, but head or neck trauma is also a recognized risk factor.

Observation:

• A 6-year-old male presented with aphasia and right hemiparesis 4 days post-fall.
• Magnetic resonance angiography revealed tandem occlusion of the left internal carotid artery (ICA) and middle cerebral artery.
• Endovascular exploration identified and successfully recanalized an ICA dissection.

Findings:

• Neurointerventional embolectomy resulted in full neurological recovery.
• The patient remained free of recurrence at a 2-year follow-up.
• This case demonstrates a positive outcome following embolectomy for pediatric AIS secondary to trauma.

Implications:

• The safety and efficacy of therapeutic embolectomy in pediatric AIS require further investigation.
• This case supports the need for novel protocols in managing childhood stroke.
• Early diagnosis and intervention are crucial for favorable outcomes in pediatric AIS.