Picture of the Month—Quiz Case

Iván Sánchez Fernández, Jurriaan M. Peters
2009 Archives of Pediatrics & Adolescent Medicine  
A 2-MONTH-OLD, PREVIOUSLY HEALTHY INfant developed partial seizures, eventually controlled by phenobarbital, levetiracetam, and lamotrigine. The results of imaging studies and metabolic workup were normal. He was born full term after an uncomplicated pregnancy and delivery to healthy parents of Indian descent. His development had been unremarkable. At the age of 5 months, he had a left hemiparesis due to arightanteriorcerebralarterystroke.Attheageof11months, he presented with a right
more » ... and focal right-sided seizures from a left middle cerebral artery stroke (Figure 1) . The results of cardiologic evaluation, including cardiac ultrasonography,werenormal.Extensivehematologicworkup and genetic screening for a hypercoagulable state were unrevealing. Magnetic resonance imaging and the concurrent magnetic resonance angiogram prompted a conventional 4-vessel angiogram (Figure 2 ).
doi:10.1001/archpediatrics.2008.520-a pmid:19188651 fatcat:lv2qv5pabranxoybxxs5yu24zu