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Journal of Pediatric Neurology 2011; 09(02): 233-237
DOI: 10.3233/JPN-2011-0464
Georg Thieme Verlag KG Stuttgart – New York

A case of carotid artery dissection suggesting ADEM

Jennifer C. Walker
a   Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
,
Wim Brussel
a   Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
,
Corrie E. Erasmus
b   Department of Pediatric Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Publication History

17 November 2009

26 February 2010

Publication Date:
30 July 2015 (online)

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Abstract

We present a case of a boy with recurrent left-sided hemiparesis. Early magnetic resonance imaging showed features suggesting acute disseminated encephalomyelitis (ADEM). However, he deteriorated neurologically on high dose methylprednisolone. A follow-up cerebral magnetic resonance imaging showed an extensive infarction due to carotid artery dissection. Distinguishing features between ADEM and acute stroke in childhood are described, but at early stage, it might be difficult to distinguish ADEM from acute stroke.

Keywords

ADEM - carotid artery dissection - clinical phenomena - MRI - diffusion-weighted imaging