Signs and Symptoms

The hallmark sign of an arterial dissection in children is any symptom of an ischemic stroke, particularly weakness on one side of the body. Other effects of stroke may include:

• Sudden onset of difficulty with speaking, such as slurred or garbled speech
• Seizures
• Sudden onset of partial or complete blindness

Although adults with an arterial dissection typically experience headaches and head and neck pain, these symptoms are less common in children.

Diagnosis

Because the vast majority of children with an arterial dissection experience symptoms of ischemic strokes, it is important that in addition to being evaluated for stroke, your child also be tested for an underlying arterial dissection. In the past, arterial dissections have been considered rare in children, although this may be due in part to missed diagnosis. Advances in imagining diagnostic tools, such as magnetic resonance angiography, have greatly improved the ability to accurately diagnose arterial dissections.

Magnetic Resonance Angiography (MRA) is a magnetic resonance imaging (MRI) study of the blood vessels. Using a strong magnetic field, a MRI can generate a three-dimensional image of the brain that can be used to detect, diagnose and aid the treatment of various conditions. A MRA provides detailed images of blood vessels. The procedure is painless, and the magnetic field is not known to cause tissue damage of any kind.

Treatment

Although most arterial dissections heal on their own, most children with dissections require treatment to prevent further ischemic strokes while the dissection heals. The most common therapy for arterial dissections in children is an anti-thrombotic medicine, such as coumadin or aspirin, which slows blood clotting. In rare cases, surgical repair of the arterial dissection may be required.