Otake Saori, Tajima Yosuke, Hayasaka Michihiro, Sugiyama Tomohiro
Department of Neurosurgery, Kimitsu Chuo Hospital, Kisarazu City, Chiba, Japan.
Asian J Neurosurg. 2020 Aug 28;15(3):716-718. doi: 10.4103/ajns.AJNS_146_20. eCollection 2020 Jul-Sep.
A 10-year-old girl was transferred to our hospital with left hemiparesis. Diffusion-weighted magnetic resonance imaging (MRI) of the brain showed a signal lesion in the right posterior limb of the internal capsule and magnetic resonance angiography showed poor visualization of the right internal carotid artery (ICA), and a defect area was present in a part of the supraclinoid portion of the right ICA. Based on the clinical and radiological findings, the patient was diagnosed with ischemic stroke due to right ICA dissection (ICAD). She received 5 days of intravenous argatroban followed by oral aspirin. A month later, her hemiparesis markedly improved. As early diagnosis of ICAD is crucial for prompt treatment in children with unexplained gross neurologic abnormalities, this disease should be suspected and MRI should be performed even without a history of blunt trauma to the head and neck.
一名10岁女孩因左侧偏瘫被转诊至我院。脑部弥散加权磁共振成像（MRI）显示内囊右后肢有信号病变，磁共振血管造影显示右侧颈内动脉（ICA）显影不佳，右侧ICA床突上段部分存在缺损区。根据临床和影像学检查结果，该患者被诊断为右侧颈内动脉夹层（ICAD）所致缺血性卒中。她接受了5天的静脉注射阿加曲班治疗，随后口服阿司匹林。一个月后，她的偏瘫明显改善。由于ICAD的早期诊断对于不明原因严重神经功能异常儿童的及时治疗至关重要，即使没有头颈部钝性外伤史，也应怀疑此病并进行MRI检查。
