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Cerebellar infarction from a traumatic vertebral artery dissection in a child
1Division of Neurosurgery, Children's Hospital, Ohio State University Hospitals, Columbus 43210, USA. kim.588@osu.edu
Insights
Pediatric cerebellar infarction from traumatic vertebral artery dissection is rare. Trauma is a common cause, and this case highlights lower cervical artery involvement, necessitating consideration in children with posterior circulation ischemia.
Area of Science:
- Neurology
- Pediatric Neurology
- Vascular Neurology
Background:
- Vertebral artery dissection leading to infarction is uncommon in children.
- Trauma is frequently identified as a preceding event in pediatric vertebral artery dissection.
- The C1-2 level is the most common site for traumatic vertebral artery dissection.
Observation:
- This report details a pediatric case of cerebellar infarction secondary to traumatic vertebral artery dissection.
- The dissection involved the lower cervical segment of the vertebral artery, differing from the typical C1-2 level.
- The patient presented with acute symptoms and signs of posterior circulation ischemia.
Findings:
- Cerebellar infarction can result from vertebral artery dissection in children.
- Traumatic vertebral artery dissection can occur at lower cervical levels, not exclusively at C1-2.
- Magnetic resonance imaging (MRI) and MR angiography are valuable diagnostic tools.
Implications:
- Vertebral artery dissection should be considered in the differential diagnosis for pediatric posterior circulation ischemia.
- Early diagnosis and appropriate management are crucial for outcomes in pediatric stroke.
- This case expands the understanding of anatomical locations for traumatic vertebral artery dissection in children.
Abstract:
Infarction due to vertebral dissection is a rarely reported event in children. We describe the clinical presentation, radiological findings and surgical treatment of a child with cerebellar infarction resulting from a traumatic vertebral artery dissection. Review of the literature on stroke due to a vertebral artery dissection in the pediatric population shows that trauma is a common preceding event. Although the most common site of traumatic vertebral artery dissection is at C1-2 level, our case illustrates that the vertebral artery dissection may also involve the lower cervical segment. We emphasize that vertebral artery dissection should be considered in a child with acute symptoms and signs of posterior circulation ischemia and that MRI and MR angiography may be helpful in the diagnosis of infarction and vertebral artery dissection.