Korean J Crit Care Med.  2013 May;28(2):119-122. 10.4266/kjccm.2013.28.2.119.

Cerebral Ischemic Stroke in an Infant with Acute Myocarditis: A Case Report

• Lee GH
• Kim YH

• KMID: 2227857
• DOI: http://doi.org/10.4266/kjccm.2013.28.2.119

Abstract

A 9-month-old infant presented with cough, tachypnea, and grunting was admitted. The patient was revealed to have cardiomegaly, high NT-proBNP, and severe left ventricular dilation and dysfunction; she was subsequently diagnosed with acute myocarditis and congestive heart failure. Intravenous immunoglobulin, inotropics, diuretics, angiotensin converting enzyme inhibitors and beta blocker were used. However, left hemiparesis suddenly developed at 30-day after treatment. Brain MRI showed high signal intensity in the right middle cerebral arterial territory on diffusion weighted brain MRI and in the left parietal lobe with gyral enhancement. Echocardiogram revealed no definite intraventricular thrombus. The patient was started on an antiplatelet agent only without anticoagulant therapy for the treatment of cerebral infarct in respect of the risk to the infant. Four years after the cerebral ischemic stroke (CIS), she showed complete recovery from hemiparesis, with no more CIS. In conclusion, severe ventricular dilatation and dysfunction can lead to thromboembolic events in infants. We should keep in mind that anticoagulant or antiplatelet agents can be used in specific situations.

Keyword

infant; myocarditis; stroke

MeSH Terms

Angiotensin-Converting Enzyme Inhibitors
Brain
Cardiomegaly
Cough
Diffusion
Dilatation
Diuretics
Heart Failure
Humans
Immunoglobulins
Infant
Myocarditis
Natriuretic Peptide, Brain
Paresis
Parietal Lobe
Peptide Fragments
Platelet Aggregation Inhibitors
Stroke
Tachypnea
Thrombosis
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Immunoglobulins
Natriuretic Peptide, Brain
Peptide Fragments
Platelet Aggregation Inhibitors