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Case 319.

Catherine Wing Yan Tam¹, King Kenneth Cheung¹

¹From the Department of Radiology, North District Hospital, 9 Po Kin Road, Sheung Shui, Hong Kong (C.W.Y.T.); and Centre for Medical Imaging, University College London, London, UK (K.K.C.).

|July 25, 2023

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This case study highlights a rare pediatric stroke presentation in a young girl with a complex medical history. Early recognition and advanced neuroimaging are crucial for diagnosing such critical neurological events.

Area of Science:

Pediatric Neurology
Neuroimaging
Stroke Medicine

Background:

A 7-year-old girl presented with acute neurological deficits including hemiplegia and aphasia.
She had a history of prior strokelike episodes and significant congenital medical conditions.

Purpose of the Study:

To report a complex pediatric stroke case.
To emphasize the importance of comprehensive evaluation in young stroke patients.

Main Methods:

Clinical presentation and history review.
Neurological examination and Glasgow Coma Scale assessment.
Laboratory investigations including lactate and coagulopathy work-up.
Brain Magnetic Resonance Imaging (MRI) and MR angiography.

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Main Results:

The patient exhibited right-sided hemiplegia, expressive aphasia, and bulbar palsy.
Previous strokelike episodes and a history of patent ductus arteriosus, dysautonomia, and other conditions were noted.
Mildly elevated venous lactate was observed; coagulopathy work-up was normal.

Conclusions:

Pediatric stroke can present with diverse symptoms and in patients with complex comorbidities.
Advanced neuroimaging like MRI and MR angiography are essential for diagnosis.
A thorough medical history is critical for understanding potential underlying causes and risk factors.