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Strokes in children due to vertebral artery trauma
B P Garg1, C J Ottinger, R R Smith
1Department of Neurology, Indiana University School of Medicine, Indianapolis.
Insights
Vertebral artery lesions causing stroke are rare in children, predominantly affecting boys. Traumatic lesions at C1-2 are common, with good recovery prospects, suggesting consideration for posterior circulation ischemia.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Neurotrauma
Background:
- Strokes in children are uncommon, and those attributed to vertebral artery lesions are particularly rare.
- Understanding the etiology and outcomes of pediatric vertebral artery lesions is crucial for timely diagnosis and management.
Observation:
- This study reviews three new pediatric cases of stroke secondary to vertebral artery lesions.
- These cases are analyzed alongside 16 previously reported cases from the literature.
- A notable observation is that all affected patients in the combined cohort are male.
Findings:
- Traumatic vertebral artery lesions, specifically at the C1-2 level, were identified as the most frequent cause of stroke in this pediatric cohort.
- The overall prognosis for neurological recovery in these young patients was found to be favorable.
- Posterior circulation ischemia in boys should prompt consideration of vertebral artery disease.
Implications:
- The findings suggest that vertebral artery dissection should be considered in the differential diagnosis of posterior circulation stroke in male children.
- Early recognition and appropriate management of traumatic vertebral artery lesions may improve neurological outcomes.
- Further research into the specific mechanisms and risk factors for vertebral artery lesions in pediatric males is warranted.
Abstract:
Strokes due to vertebral artery lesions are rare in children. We describe three new patients and compare them with the 16 other patients described in the literature. All of these patients are boys. Traumatic vertebral artery lesion at C1-2 level was the most common cause of stroke, and the prognosis for neurologic recovery was good. We suggest that vertebral artery disease be considered in boys with posterior circulation ischemia.