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Symptomatic Intracranial Vertebral Artery Dissection in a Pediatric Patient with Newly Diagnosed Takayasu Arteritis and Disseminated Tuberculosis: A Case Report

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Abstract

Pediatric arterial ischemic strokes present a unique diagnostic challenge because of the complex work-up needed to identify an underlying pathology. We report a 17-year-old female presenting with a left lateral caudal pontine syndrome. Neuroimaging revealed a left anterior inferior cerebellar artery infarct from a symptomatic left intracranial vertebral artery dissection. Further work-up revealed Takayasu arteritis and disseminated tuberculosis. The incidence of intracranial vertebral artery dissection is not known, and there is paucity of literature documenting its occurrence in the pediatric age group, more so on the background of a large vessel vasculitis and a disseminated tuberculous infection. This case report presents and discusses a rare pathomechanism of pediatric stroke and emphasizes the importance of a complete work-up so that proper management may be instituted.

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Data Availability

No datasets were generated or analysed during the current study.

Code Availability

Not applicable.

Abbreviations

AICA:

Anterior-inferior cerebellar artery

AIS:

Acute ischemic stroke

BP:

Blood pressure

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

cTA:

Childhood Takayasu arteritis

CTA:

Computed tomography angiogram

ESR:

Erythrocyte sedimentation rate

EULAR:

European League Against Rheumatism

IAD:

Intracranial arterial dissection

KD:

Kawasaki disease

LVV:

Large vessel vasculitis

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

NIHSS:

National Institutes of Health Stroke Scale

PAIS:

Pediatric arterial ischemic stroke

PAN:

Panarteritis nodosa

PRES:

Pediatric Rheumatology European Society

PRINTO:

Pediatric Rheumatology International Trials Organization

TB:

Tuberculosis

VA:

Vertebral artery

VAD:

Vertebral artery dissection

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Author information

Authors and Affiliations

  1. Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines

    Jao Jarro B. Garcia

  2. Division of Pediatric Neurology, Departments of Pediatrics and Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines

    Elbert John V. Layug & Marilyn A. Tan

Authors
  1. Jao Jarro B. Garcia
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  2. Elbert John V. Layug
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  3. Marilyn A. Tan
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Contributions

JJBG – conceptualization, investigation, writing – original draft EJVL—conceptualization, investigation, writing – review & editing MAT—conceptualization, investigation, writing – review & editing, supervision.

EJVL, conceptualization, investigation, writing—review and editing.

MAT, conceptualization, investigation, writing—review and editing, supervision.

Corresponding author

Correspondence to Jao Jarro B. Garcia.

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Garcia, J.J.B., Layug, E.J.V. & Tan, M.A. Symptomatic Intracranial Vertebral Artery Dissection in a Pediatric Patient with Newly Diagnosed Takayasu Arteritis and Disseminated Tuberculosis: A Case Report. SN Compr. Clin. Med. 7, 6 (2024). https://doi.org/10.1007/s42399-024-01762-7

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