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Face-off Droop: A Case Report of Pediatric Stroke

Robertson, Duncan
Peirce, Hayden F
Nicpon, Marek D
Otterson, Eric M
O'Connor, Laurel
Rissmiller, Julia G
Binder, Zachary W
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Abstract

Introduction: Cerebrovascular accidents rarely occur in children; the incidence of ischemic stroke in patients <16 years of age is between 0.6-7.9/100,000. However, they are the fourth most common cause of acute neurological deficits in the pediatric population, and possible cases should be evaluated with a high index of suspicion to ensure timely intervention.

Case report: We describe a previously healthy 17-year-old male who presented to the pediatric emergency department with a left facial droop and hemiparesis consistent with a stroke. The patient's age and lack of comorbidities made this an extremely uncommon presentation. Our patient's neurologic symptoms were believed to have been caused by a recent traumatic clavicular injury sustained two weeks prior, which subsequently led to vascular insult.

Conclusion: Cerebrovascular accidents are an important cause of morbidity and mortality in pediatric patients. Cerebrovascular accidents in children are most often secondary to congenital causes; however, care should be taken to assess for acquired causes, such as trauma to major blood vessels. While rarely implicated in traumatic injuries, arterial structures posterior to the medial clavicle can result in severe complications.

Source

Robertson D, Peirce HF, Nicpon MD, Otterson EM, O'Connor L, Rissmiller JG, Binder ZW. Face-off Droop: A Case Report of Pediatric Stroke. Clin Pract Cases Emerg Med. 2024 May;8(2):120-124. doi: 10.5811/cpcem.6586. PMID: 38869333; PMCID: PMC11166058.

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10.5811/cpcem.6586
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38869333
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Funding and Acknowledgements
The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR001454. The NIH had no role in the design and conduct of the study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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Copyright © 2024 Robertson et al.. This work is made available under the terms of a Creative Commons Attribution License, available at https://creativecommons.org/licenses/by/4.0/; Attribution 4.0 International