1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-8-71-a 10.15844/pedneurbriefs-8-9-11 Vascular Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Traumatic Vertebral Artery Dissection http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 09 1994 01 06 2016 8 9 71 71 Copyright: © 1994 The Author(s) 1994 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Stroke due to a traumatic vertebral artery dissection in a girl

A girl, aged 9 years, with cerebellar infarction following minor neck injury sustained while ice-skating is reported from West Virginia University, Morgantown, WV.

 Hemispheres Cerebellar Vermian Lesion Traumatic Vertebral Artery Stroke

A girl, aged 9 years, with cerebellar infarction following minor neck injury sustained while ice-skating is reported from West Virginia University, Morgantown, WV. Symptoms began 12 hours after the fall, with vomiting that awakened her from sleep and recurred hourly. She complained of a throbbing occipital headache, stiff neck, photophobia, dizziness on standing, and ataxia. She had horizontal nystagmus, dysmetria bilaterally, and she stood and walked only with support. CT and MRI revealed a cerebellar vermian lesion extending into both hemispheres. Posterior fossa decompression and biopsy showed coagulative necrosis and no neoplasm. Vertebral angiography revealed a traumatic aneurysm within the distal right cervical vertebral artery and recanalization of an embolus in the right posterior inferior cerebellar artery with a narrowed lumen. She was treated with aspirin and recovery was complete after 3 months, with no recurrence at 1 year follow-up. [1]

COMMENT. Childhood traumatic vertebral artery stroke was previously thought to affect boys only [2]. With the increased participation of girls in contact sports, more female cases may be expected.

A further case of vertebral-artery dissection occurring in an 11-year-old boy following a judo session is reported from Besancon, France [3]. CT showed a left thalamic infarct, and angiography revealed fibromuscular dysplasia ("string of beads” lesion) of the left vertebral artery with probable dissection. With anticoagulation, bed rest, and a cervical soft collar, symptoms of headaches, vomiting, left ptosis and diplopia, dysphasia, and ataxia resolved, and the boy was discharged taking aspirin after 2 weeks.

 Sheth RJ Jaynes M Gingold M Ortiz O Bodensteiner JB Stroke due to a traumatic vertebral artery dissection in a girl Clin Pediatr 1994 Aug 33 8 503 506 10.1177/000992289403300811 7955794 Garg BP Ottinger CJ Smith RR Fishman MA Strokes in children due to vertebral artery trauma Neurology 1993 Dec 43 12 2555 2558 10.1212/WNL.43.12.2555 8255456 Lannuzel A Moulin T Amsallem D Galmiche J Rumbach L Vertebral-artery dissection following a judo session: a case report Neuropediatrics 1994 Apr 25 2 106 108 10.1055/s-2008-1071595 8072674