Prangwatanagul Wasana, Limsuwan Alisa
Division of Pediatric Cardiology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pediatr Int. 2017 Jan;59(1):92-96. doi: 10.1111/ped.13170.
Pediatric stroke is considered to be rare. Stroke resulting from cerebral vasculitis is also uncommon in young children. With the increasing prevalence of Kawasaki disease (KD) diagnosis, this acquired vasculitis has been reported with various clinical presentations including neurological symptoms. Herein we describe the case of a KD patient presenting with stroke. A 15-month-old boy was referred due to stroke that occurred on the fifth day of febrile illness. He was initially admitted to another hospital due to fever and diarrhea. He was discharged and re-admitted 2 days afterward due to left hemiplegia. During the 10 days of the second hospitalization, he had a presumptive diagnosis of encephalomeningitis. Upon referral to the present hospital, he was found to have right middle cerebral artery branch stenosis and fusiform aneurysms of the coronary arteries. Retrospectively, the patient had the full clinical criteria for KD diagnosis. Therefore, stroke could be considered as one of the uncommon clinical manifestations of KD.
小儿中风被认为较为罕见。由脑血管炎导致的中风在幼儿中也不常见。随着川崎病(KD)诊断率的不断上升,这种获得性血管炎已被报道有包括神经症状在内的各种临床表现。在此我们描述一例以中风为表现的KD患者。一名15个月大的男孩因发热性疾病第5天发生中风而被转诊。他最初因发热和腹泻入住另一家医院。出院后2天因左侧偏瘫再次入院。在第二次住院的10天里,他被初步诊断为脑脑膜炎。转诊至本院后,发现他有右大脑中动脉分支狭窄和冠状动脉梭形动脉瘤。回顾性分析,该患者符合KD诊断的全部临床标准。因此,中风可被视为KD不常见的临床表现之一。