Know your stroke mimics

A developmentally normal and previously well 15-year-old boy, presented to hospital with a 4-hour history of gradually worsening, throbbing, left-sided headache spreading across his whole head. Four hours prior, he could not read properly or string words together and felt tired. He developed a headache followed by expressive aphasia, agitation and vomiting. A right-sided lower facial droop was noted that resolved in a couple of hours. He played a rugby match in the morning and there was a history of minor head injury without loss of consciousness. He started to develop self-resolving apnoeic episodes each lasting for 30–60 seconds. He initially had a CT of the brain followed by emergency MRI/MRA (magnetic resonance angiography) of the brain after being intubated and ventilated. All scans were reported as normal. Susceptibility-weighted imaging (SWI) sequences demonstrated vascular asymmetry (figure 1). The patient had been started on antiviral and antibiotic treatment for...
Source: Archives of Disease in Childhood - Education and Practice - Category: Pediatrics Authors: Tags: Epilogue Source Type: research