Robertson Duncan, Peirce Hayden F, Nicpon Marek D, Otterson Eric M, O'Connor Laurel, Rissmiller Julia G, Binder Zachary W
University of Massachusetts, Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts.
University of Massachusetts, Chan Medical School, Department of Pediatrics, Worcester, Massachusetts.
Clin Pract Cases Emerg Med. 2024 May;8(2):120-124. doi: 10.5811/cpcem.6586.
Cerebrovascular accidents rarely occur in children; the incidence of ischemic stroke in patients <16 years of age is between 0.6-7.9/100,000. However, they are the fourth most common cause of acute neurological deficits in the pediatric population, and possible cases should be evaluated with a high index of suspicion to ensure timely intervention.
We describe a previously healthy 17-year-old male who presented to the pediatric emergency department with a left facial droop and hemiparesis consistent with a stroke. The patient's age and lack of comorbidities made this an extremely uncommon presentation. Our patient's neurologic symptoms were believed to have been caused by a recent traumatic clavicular injury sustained two weeks prior, which subsequently led to vascular insult.
Cerebrovascular accidents are an important cause of morbidity and mortality in pediatric patients. Cerebrovascular accidents in children are most often secondary to congenital causes; however, care should be taken to assess for acquired causes, such as trauma to major blood vessels. While rarely implicated in traumatic injuries, arterial structures posterior to the medial clavicle can result in severe complications.
脑血管意外在儿童中很少发生；16岁以下患者缺血性中风的发病率在0.6-7.9/10万之间。然而，它们是儿科人群急性神经功能缺损的第四大常见原因，对于可能的病例应高度怀疑并进行评估，以确保及时干预。
我们描述了一名此前健康的17岁男性，他因左侧面部下垂和偏瘫来到儿科急诊科，症状与中风相符。患者的年龄和无合并症使得这种表现极为罕见。据信，我们这位患者的神经症状是由两周前最近遭受的锁骨创伤引起的，随后导致了血管损伤。
脑血管意外是儿科患者发病和死亡的重要原因。儿童脑血管意外最常见的继发原因是先天性因素；然而，应注意评估后天性原因，如主要血管的创伤。虽然很少与创伤性损伤有关，但锁骨内侧后方的动脉结构可导致严重并发症。
