# Face-off Droop: A Case Report of Pediatric Stroke

## TL;DR

A 17-year-old healthy boy experienced a stroke due to a recent clavicular injury, highlighting the rare but serious link between trauma and pediatric strokes.

## Contribution

This case report highlights an uncommon cause of stroke in adolescents, linking traumatic clavicular injury to cerebrovascular complications.

## Key findings

- A previously healthy adolescent presented with stroke symptoms following a traumatic clavicular injury.
- The case underscores the importance of considering acquired causes, such as trauma, in pediatric stroke evaluations.

## Abstract

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.

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.

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.