Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A child who developed internal carotid artery obstruction 2 weeks after incurring an intraoral blunt injury: A case report

Ryuhei Kono, M.D.1), Shinzo Ota, M.D.2), Yutaka Shimoe, M.D., Ph.D.1), Akio Tanaka. M.D., Ph.D.3) and Masaru Kuriyama, M.D., Ph.D.1)

1)Department of Neurology, Brain Attack Center Ota Memorial Hospital
2)Department of Neurosurgery, Brain Attack Center Ota Memorial Hospital
3)Department of Radiology, Brain Attack Center Ota Memorial Hospital

This report describes a 9-year-old boy with an internal carotid artery (ICA) injury caused by a fall with the blunt edge of a toothbrush held in the mouth. The initial injury appeared trivial, but 2 weeks later, generalized convulsion and left hemiparesis occurred. Magnetic resonance imaging and magnetic resonance angiography revealed an infarction of the right striatum, right ICA occlusion, and stenosis of the right middle cerebral artery, which were caused by the dissection or intimal damage of the ICA due to the blunt trauma. For children, intraoral blunt trauma sometimes causes ICA occlusion and consecutive strokes after the latent interval of days to weeks. Therefore, a careful clinical observation is essential to prevent overlooking strokes. This patient was an unique case with a long latent interval among the past literatures.
Full Text of this Article in Japanese PDF (487K)

(CLINICA NEUROL, 55: 501|504, 2015)
key words: toothbrush, blunt injury, intraoral injury, internal carotid artery occlusion, cerebral infarction

(Received: 26-Jan-15)