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Pediatric Bow Hunter Syndrome, a case report.

OBJECTIVE: Describe a pediatric patient with Bow Hunter diagnosis

CASE REPORT: A healthy 8-year-old patient presented with headache, nausea and left brachiocrural hemiparesis after sports practice, without experiencing any kind of trauma. Restrictive lesions were evidenced on brain Magnetic Resonance Imaging (MRI) along left vertebral artery territory. Brain CT 3D reconstruction showed a left-sided paracondylar process, which constricted V3 and V4 segments of the left vertebral artery (LVA). Dissection of the horizontal portion of V3 and a thrombus within were evidenced by digital angiography. Initial treatment consisted of cervical immobilization. Two new ischemic events in the posterior territory were subsequently identified. The patient underwent surgical removal of the bone defect, with no complications, and has remained asymptomatic ever since.

CONCLUSION: Ischemic stroke involving the posterior territory is rare in the pediatric population. Local vasculopathy is the most frequent cause in this age group. Neuropediatricians must be alert to explore cranio-cervical and vascular anatomy with adequate images.
Keywords: Vertebral artery, Ischemic stroke, Dissection, Bone anomaly.

Ángeles Schteinschnaider
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

Romina Nélida Dominguez
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

María Sol Voyame
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

Isaura Gonzalez
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

Martín Carnevale
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

Paulina Yañez
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

Romina Goñi
Raúl Carrera Institute for Neurological Research - FLENI
Argentina

 

 


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