Tekin S, Aykut-Bingöl C, Aktan S
Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey.
Pediatr Neurol. 1997 Jan;16(1):67-70. doi: 10.1016/s0887-8994(96)00252-4.
Stroke in childhood is rare and has its own characteristic findings. Vertebrobasilar ischemia due to trauma in this age group has been described, but its specific features have not yet been clearly defined. Dissection of vertebral artery is one of the causes of vertebrobasilar ischemia that is very uncommonly detected in the intracranial portion of the posterior circulation in childhood. We report a 14-year-old boy with a history of neck trauma and transient vertigo attacks who presented with brainstem and cerebellar ischemic findings. Due to the large left cerebellar infarct size compressing the fourth ventricle, we performed emergent posterior fossa decompression. Digital cerebral subtraction angiography revealed left vertebral artery dissection beginning at the V1 portion to the level of V4 and distal thrombosis of basilar artery. After 2 months, he was discharged from the hospital with minor neurologic deficit with anticoagulation therapy. Due to better outcome in childhood, early investigation for intracranial dissection should be included in the evaluation of posterior circulation infarcts in this age group.
儿童期中风较为罕见且有其自身的特征性表现。该年龄组因外伤导致的椎基底动脉缺血已有相关描述，但其具体特征尚未明确界定。椎动脉夹层是椎基底动脉缺血的病因之一，在儿童后循环颅内部分极为罕见。我们报告一名14岁男孩，有颈部外伤史和短暂性眩晕发作，出现脑干和小脑缺血表现。由于左侧小脑梗死灶较大压迫第四脑室，我们进行了急诊后颅窝减压术。数字减影血管造影显示左侧椎动脉夹层起自V1段至V4段水平，基底动脉远端血栓形成。2个月后，他经抗凝治疗出院，遗留轻度神经功能缺损。鉴于儿童期预后较好，对于该年龄组后循环梗死的评估应包括对颅内夹层的早期检查。
