Trivial Neck Bite Resulting in a Stroke in an 18-Month-Old Child: A Case Report

TL;DR

An 18-month-old child suffered a stroke after a minor neck bite, highlighting the need to consider stroke in children with head or neck injuries.

Contribution

This case report highlights the risk of stroke from minor head and neck trauma in children.

Findings

An 18-month-old child developed stroke symptoms after a trivial neck bite.

Imaging revealed a right MCA infarction with no arterial dissection or stenosis.

The case emphasizes the importance of considering stroke in pediatric trauma cases.

Abstract

Stroke is often viewed as a diagnosis found In the elderly with or without comorbidities, but it is vital to not rule it out in a pediatric patient presenting with signs and symptoms of stroke. Here, we present a case of an 18-month-old boy who arrived at the emergency department with left arm weakness and left-sided seizures a few minutes after a right-sided trivial neck bite that was initially overlooked by the parents until symptoms occurred. Urgent imaging further with a computed tomography scan of the brain revealed a hypodense lesion in the area covering the lateral part of the frontal lobe, insula, and parietal cortex of the right hemisphere. Subsequent CT cervical-cerebral angiogram revealed normal aortic arch, carotid, and vertebral arteries with no dissection, stenosis, or occlusion. However, there was a 4 mm-long occlusion of the M2 segment of the right middle cerebral artery (MCA) suggestive of emboli and subsequent low attenuation of the brain parenchyma in the anterior aspect of the right MCA vascular territory corresponding with the infarction. The objective of this case report is to educate and inform both parents and medical professionals regarding the risk of neurological damage that can occur with minor head and neck trauma that is often overlooked and therefore the importance of ruling it out with necessary imaging modalities.

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