Internal Carotid Artery Occlusion in a Child

Occlusion of the internal carotid artery is a rare condition in children.Mymin (1960) and Wisoff and Rothballer (1961) reviewed a total of 24 cases in children under the age of 10 years.Till and Hoare (1962) published carotid arteriograms of 3 children who presented with acute hemiplegia but they gave no additional clinical details.Brandt (1962) also mentioned a case of acute infantile hemiplegia due to internal carotid stenosis.Faris, Guth, Youmans, and Poser (1964) reported the case of a 7-year-old girl who presented with a left hemiplegia due to occlusion of the right internal carotid artery.The following case is reported because of the comparative rarity of the condition, and in addition because it seems to be the first in which the pathology was demonstrated surgically and found to be amenable in part to corrective surgery.Case Report L.K. was born in 1957 following a normal pregnancy and uncomplicated confinement, birth weight being 7 lb. 2 oz.(3 * 2 kg.).He was the seventh child in a family of eight.His parents and sibs are perfectly well and there is no family history of febrile convulsions or epilepsy.The child was well until August 1961 when he was found unconscious in bed.He recovered consciousness fully within a few minutes.His parents did not notice any twitching and there was no incontinence.He was admitted to the Brisbane Children's Hospital and was found to have an upper respiratory tract infection with an associated fever.Physical examination at that stage did not reveal any abnormalities.Carotid artery pulses were not commented upon at that admission.He remained well until December 1962 when, following a minor disagreement with his mother, without warning he fell to the floor and was found to be unable to move his left arm or left leg.He could not speak but he did not lose consciousness and he seemed to understand what was said to him.No twitching was observed.The weakness lasted about ten minutes and then disappeared spontaneously, and speech returned.Twenty-four hours later