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Journal of Child Neurology
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Late Complications of Vertebral Artery Dissection in Children: Pseudoaneurysm, Thrombosis, and Recurrent Stroke

Marilyn A. Tan, MD

Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada

Derek Armstrong, MD

Division of Radiology, Hospital for Sick Children, Toronto, Ontario, Canada

Daune L. MacGregor, MD

Division of Neurology Alberta Children's Hospital, Calgary, Alberta, Canada

Adam Kirton, MD, MSc

Division of Neurology, Alberta Children's Hospital, Calgary, Alberta, Canada, adam.kirton@calgary healthregion.ca

Craniocervical arterial dissection is an important cause of childhood arterial ischemic stroke, accounting for 7.5% to 20% of cases. Significant neurologic morbidity and mortality may result and recurrence risk may be higher than in adults. However, the natural history and long-term outcome of pediatric dissection are poorly studied. We report 3 cases of extracranial vertebral artery dissection with complications including pseudoaneurysm formation, recurrent stroke, and late spontaneous thrombosis of the dissected artery. These cases illustrate the dynamic processes involved in vascular injury and healing of vertebral artery dissection in children over years, with potential implications for long-term management and prevention of recurrence.

Key Words: vertebral artery • dissection • pseudo-aneurysm • stroke

Journal of Child Neurology, Vol. 24, No. 3, 354-360 (2009)
DOI: 10.1177/0883073808324775
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