Spontaneous recanalization of pediatric internal carotid artery dissection during aspirin monotherapy: a retrospective case series.
Ting Tang, Tong Jin, Zhi Li et al.
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Case in brief
This retrospective series described five children with acute arterial ischemic stroke due to intracranial internal carotid artery dissection. All presented with hemiparesis, and two also had seizures; two dissections followed definite trauma and three were spontaneous. Evaluation did not support large-vessel vasculitis. Each child received aspirin monotherapy (3-5 mg/kg/day) for secondary prevention. MRI/MRA at discharge showed complete recanalization of the affected artery in all five, and neurological deficits resolved or improved substantially.
What made this case unusual
Complete recanalization was seen on discharge imaging in all five children, including those with spontaneous as well as traumatic dissections, during aspirin monotherapy.
Diagnostic / clinical pearl
In a child with acute hemiparesis, consider ICA dissection as a cause of ischemic stroke; vascular imaging follow-up can document recanalization.