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Vertebral artery dissection with bilateral hemiparesis

I N Horowitz1, N A Niparko

  • 1Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048-1869.

Pediatric Neurology
|October 1, 1994
PubMed
Summary

Traumatic vertebral artery dissection in a child caused cerebellar and thalamic infarcts, leading to hemiparesis and ataxia. Posterior circulation injury is a key consideration for pediatric vertebrobasilar insufficiency.

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Area of Science:

  • Neurology
  • Pediatric Neurology
  • Vascular Neurology

Background:

  • Vertebral artery dissection (VAD) is a rare but serious condition.
  • While more common in adults, VAD can occur in children following trauma.
  • Posterior circulation stroke in children necessitates thorough etiological investigation.

Observation:

  • A 5-year-old child presented with acute onset hemiparesis and ataxia.
  • Clinical presentation suggested vertebrobasilar insufficiency.
  • Cerebral magnetic resonance imaging and angiography confirmed right vertebral artery dissection.

Findings:

  • The vertebral artery dissection resulted in cerebellar and thalamic infarcts.
  • An arterial thrombus with subsequent embolization was identified as the cause.

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  • The child's neurological deficits were attributed to these ischemic events.
  • Implications:

    • Traumatic vertebral artery dissection should be considered in pediatric cases of posterior circulation stroke.
    • Prompt diagnosis and management are crucial for improving outcomes in pediatric VAD.
    • This case highlights the importance of evaluating traumatic vascular injuries in the pediatric population.