J Korean Child Neurol Soc Search

CLOSE


Ann Child Neurol > Volume 25(1); 2017 > Article
Journal of the Korean Child Neurology Society 2017;25(1):48-53.
DOI: https://doi.org/10.26815/jkcns.2017.25.1.48    Published online March 30, 2017.
A Case of Spontaneous Internal Carotid Artery Dissection Presenting as a Seizure without Focal Neurologic Signs.
Seung Yun Lee, JunBum Park, Myoung Sook Lee, Kyung Yeon Lee
1Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. pdsnoopy@naver.com
2Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Abstract
Craniocervical artery dissection is an uncommon cause of acute ischemic stroke in children, although it is an important cause of stroke in young and middle-aged patients. Among craniocervical artery dissection, internal carotid artery (ICA) dissection usually presents with focal neurologic deficits, such as acute hemiparesis. However, if it presents with only non-localizing signs, such as headache and seizure, ICA dissection may be overlooked in a differential diagnosis. Here we describe an 8-year-old boy who had spontaneous internal carotid artery dissection presenting as a seizure without focal neurologic signs. The patient was admitted to the emergency department because of seizure. On arrival at the emergency department, focal neurologic signs, such as motor weakness, were not observed. The patient had no recent trauma history. Magnetic resonance imaging revealed diffusion-restriction in the left basal ganglia. Magnetic resonance angiography, computed tomography angiography, and cerebral angiography demonstrated occlusion of the left distal ICA with tapered stenosis (so-called “string sign”). The patient was treated with aspirin and oxcarbazepine to prevent thrombosis and further seizures. Three-month follow-up MRA revealed apparent improvement of the occlusion of the left distal internal carotid artery. The patient had no neurologic deficits or further seizures in the outpatient clinic 13 months after discharge. This case demonstrated that acute ischemic stroke resulting from ICA dissection can occur with seizures without focal neurologic signs. In addition, ICA dissection should be considered as a possible cause of acute ischemic stroke even in children with no history of trauma.
Key Words: Internal carotid artery dissection, Seizures, Neurologic manifestations, Child


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
EDITORIAL POLICY
AUTHOR INFORMATION
Editorial Office
50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2019-3350    Fax: +82-2-2019-4881    E-mail: editor@annchildneurol.org                

Copyright © 2019 by Korean Child Neurology Society. All rights reserved.

Developed in M2community

Close layer
prev next