< GRAND ROUND CASE >
Year : 2004 | Volume : 50 | Issue : 2 | Page : 123-124
Cerebral infarction in a 17-year-old boy
뇌경색에 걸린 17살의 소년
How to cite this article:
How to cite this URL:
Q: What is the most likely diagnosis in this patient based on clinical history and examination?
Q: What are the likely factors predisposing to cerebral infarction in this patient?
A 17-year-old boy presented with a history of sudden onset headache, vomiting, weakness of the right half of the body and inability to speak for 24 hours. There was no history of trauma, seizure, fever or any such episode in the past. There was a significant history of a syncopal attack 15 days prior to the episode during which the patient had suffered a minor laceration on the forehead.
17살의 한 소년은 현재 갑작스럽게 시작되는 두통과 구토, 몸의 오른쪽 쇠약, 24시간 동안 말할 수 있는 능력이 없는 상태이다. 외상과 발작, 고열의 경험은 과거에 없었다. 중대한 과거력이 있는데 실신성 발작이 있긴 15일 전에 이마에 경증 열상이 있었다.
Examination revealed an aphasic agitated boy with a pulse rate of 40 per minute and a blood pressure of 180/70 mm Hg in the right arm in supine position. All peripheral pulses were palpable. Cardiovascular examination revealed a grade III/VI pansystolic murmur at the apex. The first heart sound was variable in intensity and the second heart sound was wide and variably split.
1. Costa A, Talabi A, Coulter DL, Sapire DW. Capsular stroke in congenital heart block. Eur J Pediatr 1982;139:71-2.
2. Hayabuchi Y, Matsuoka S, Nili M, Suzuya H, Kuroda Y. Cerebral infarction in a patient with congenital complete heart block. Clin Cardiol 1998;21:302-3.
3. Perloff JK. Isolated congenital complete heart block. In: The Clinical Recognition Of Congenital Heart Disease, 5th edn: WB Saunders Company; 2003:46-56.
4. Coull BM, Levine SR, Brey RL. The role of antiphospholipid antibodies in stroke. Neurol Clin 1992;10:125-43. [PUBMED]
5. Molad Y, Arad A, Pinkhas J, Eynan N. Cerebral infarct associated with lupus anticoagulant in an adolescent girl: a case report with review of literature. J Adolesc Health 1991;12:399-402. [PUBMED]
6. Galli M, Luciani D, Bertolini G, Barbui T. Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of literature. Blood 2003;101:1827-32. [PUBMED] [FULLTEXT]