Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Spontaneous intracranial internal carotid artery dissection in a child with psoriasis

소아에서 건선과 함께 진단된 자발성 두개강 내 내경 동맥 박리 1례

  • Kim, Young Ok (Departments of Pediatrics, School of Medicine, Chonnam National University) ;
  • Son, Young Jun (Departments of Pediatrics, School of Medicine, Chonnam National University) ;
  • Woo, Young Jong (Departments of Pediatrics, School of Medicine, Chonnam National University) ;
  • Yun, Sook Jung (Departments of Dermatology, School of Medicine, Chonnam National University)
  • 김영옥 (전남대학교 의과대학 소아과학교실) ;
  • 손영준 (전남대학교 의과대학 소아과학교실) ;
  • 우영종 (전남대학교 의과대학 소아과학교실) ;
  • 윤숙정 (전남대학교 의과대학 피부과학교실)
  • Received : 2009.06.22
  • Accepted : 2009.08.22
  • Published : 2009.09.15
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Abstract

A 13-year-old girl with psoriasis of the elbow, trunk, and face suddenly developed a severe headache followed by left hemiparesis and facial palsy. Brain magnetic resonance imaging showed an acute infarction of the right temporofrontal lobe and basal ganglia on the T2- and diffusion-weighted images. Cerebral angiography showed pre-occlusive irregular scalloped stenosis (99%) in the proximal M1 segment of the right middle cerebral artery and a web-like stenosis at the supraclinoid portion of the right internal carotid artery (ICA) suggestive of a spontaneous intracranial ICA dissection. The patient was administered a low dose of dipyridamole, and a rehabilitation program was initiated. Headache, left motor weakness, and facial droop improved within a week. However, mild left facial palsy and reduced fine motor function of the left hand were still present after 3 weeks. We report a rare case of spontaneous intracranial ICA dissection in a child with psoriasis.

내경 동맥 박리는 드물기는 하나 소아 허혈성 뇌경색의 한 원인이며, 선행된 외상 후 발생하는 경우가 흔해 두개강 내 보다는 두개강 외에 발생하는 경우가 많다. 건선은 흔한 피부 질환 중 하나이며, 서양인에 비해 동양인에서는 그 빈도가 낮고 다른 전신 질환과 동반되어 보고되기도 한다. 건선은 혈전 색전증과 연관된 허혈성 심뇌혈관계 질환과 연관되어 보고된 바가 있기는 하지만, 혈관 박리와 연관되어 보고된 경우는 드물다. 저자들은 이전에 건선으로 치료 받고 최근 피부 증상이 악화되던 중 우측 반신 마비와 안면 마비가 발생해 내원한 13세 여아에서 자발성 두개강 내 내경 동맥 박리를 진단하여 보고하는 바이다.

Keywords

References

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