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Acute traumatic stroke: a case of bow hunter's stroke in a child
E L Duval1, R Van Coster, K Verstraeten
1Department of Paediatrics, University of Ghent, Belgium.
Insights
Bow hunter's stroke, a type of cerebellar infarction, is rare in children. This case highlights a pediatric patient experiencing this rare stroke after minor head trauma, emphasizing the need for awareness.
Area of Science:
- Neurology
- Pediatric Stroke
- Vascular Neurology
Background:
- Cerebellar infarction due to vertebrobasillar artery damage is uncommon in pediatric populations.
- In adults, activities like chiropractic manipulation and bow hunting are linked to this type of stroke.
- The rarity of acute traumatic cerebellar stroke in children necessitates case reporting and analysis.
Observation:
- An 11-year-old boy presented with deep coma following a minor occipital head injury.
- Clinical presentation suggested a stroke affecting the cerebellum and brainstem.
- The patient had recently engaged in activities potentially involving neck strain.
Findings:
- Magnetic resonance angiography revealed hypoperfusion in the left vertebral artery.
- Occlusion was identified in the posterior and anterior inferior cerebellar arteries (PICA and AICA) on the left.
- The findings confirmed a diagnosis of left cerebellar and ipsilateral medullary infarction, consistent with bow hunter's stroke.
Implications:
- This case expands the understanding of bow hunter's stroke in pediatric neurology.
- It underscores the importance of considering vascular insults in children presenting with neurological deficits after head trauma.
- Further research into pediatric risk factors and diagnostic modalities for cerebellar stroke is warranted.
Abstract:
Acute traumatic stroke of the cerebellum is rarely seen in children. In adults, chiropractical manipulation, yoga exercises, bow hunting and cervical trauma have all been associated with vertebrobasillar damage and subsequent stroke due to cerebellar infarction. We present a case of bow hunter's stroke in a child. An 11-year-old boy developed deep coma one day after minor occipital head injury due to an infarct in the left cerebellum and ipsilateral medulla oblongata. Magnetic resonance angiography (MRA) showed hypoperfusion of the left vertebral artery and occlusion of the posterior and anterior inferior cerebellar arteries (PICA and AICA respectively).