Carotid Arteritis: A Cause of Hemiplegia in Childhood

c EREBROVASCULAR accidents are less common in children than in adults but the results may be just as devastating. Until recently, diagnosis of the mechanism of the s t roke has been made either on the basis of clinical estimation, without arteriographic confirmation, or else by pathological findings. Specific therapy ordinarily has been directed only to those patients in whom bloody spinal fluid or some other evidence of spontaneous hemorrhage has been present. Children suffering sudden strokes with no evidence of intracranial hemorrhage have been less well studied, understood and treated. The etiology of the neurological deficit in many such patients is never determined accurately and a purely clinical diagnosis of arterial thrombosis, embolism or spasm, or of cortical venous thrombosis is made. Until recently there has been little antemortem documentation of cerebral arterial occlusion in childhood, and the number of reported cases is still quite small. A review of the literature made in 1960 by Wisoff and Rothballer 36 yielded 27 cases, to which they added 2 of their own. In 1962 Byers and McLean 6 in their discussion of childhood hemiplcgia and aphasia reported cerebral arterial occlusion in 4 children. Three of these are included in this report. A review of all symptomatic cercbrovascular accidents on file at the Children's Hospital Medical Center has been made for a 14year period, 1948-1962, in an effort to clarify the frequency of cerebral arterial occlusions in the pediatric age group, and to analyze their clinical course. With the interest and