{"pk":1178,"title":"Atypical Presentation of Traumatic Pediatric  Carotid Artery Dissection: A Case Report","subtitle":null,"abstract":"Introduction:\n Carotid artery dissection is a rare but serious condition manifesting with signs and symptoms that closely overlap with other more benign medical diagnoses. This vascular injury, however, can result in debilitating sequelae, including thromboembolic cerebrovascular accidents.\nCase Report:\n We describe the atypical presentation of a healthy eight-year-old male who presented to the emergency department (ED) with generalized abdominal pain and non-bloody, non-bilious emesis. These symptoms occurred nine days after he sustained blunt head trauma after a non-syncopal fall from standing while playing hockey. He was initially diagnosed with gastroesophageal reflux disease and constipation and was discharged home. The following day he developed an acute headache followed shortly by gait ataxia, prompting a return visit to the ED. Imaging of the head and neck revealed a left internal carotid artery dissection. The patient was started on intravenous unfractionated heparin and admitted to the hospital. He was later discharged symptom-free on therapeutic enoxaparin for eight weeks, followed by daily aspirin therapy.\nConclusion: \nPediatric trauma patients, especially those sustaining insult to the head and cervical spine, are at risk for craniocervical arterial injuries. This rare but dangerous pathology often manifests in a non-specific, delayed fashion making it a challenging diagnosis for physicians to make on the initial medical encounter.1,2 Maintaining a high clinical suspicion for carotid artery dissection is required to make this diagnosis and should guide a thorough history, physical examination, and appropriate imaging in orderto improve patient morbidity and mortality. This case emphasizes key clinical features and risk factors of this disease that may help emergency clinicians promptly recognize and treat this entity.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Carotid Artery Dissection"},{"word":"craniocervical artery dissection"},{"word":"pediatric trauma"},{"word":"ataxia"},{"word":"Emergency Medicine"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9qz6f8d6","frozenauthors":[{"first_name":"Duncan","middle_name":"","last_name":"McGuire","name_suffix":"","institution":"Beaumont Hospital, Department of Emergency Medicine, Royal Oak, Michigan","department":"None"},{"first_name":"Nicholas","middle_name":"","last_name":"Mielke","name_suffix":"","institution":"Oakland University William Beaumont School of Medicine, Department of Emergency Medicine, Royal Oak, Michigan","department":"None"},{"first_name":"Amit","middle_name":"","last_name":"Bahl","name_suffix":"","institution":"Beaumont Hospital, Department of Emergency Medicine, Royal Oak, Michigan","department":"None"}],"date_submitted":"2022-08-06T18:49:49Z","date_accepted":"2022-08-06T18:49:49Z","date_published":"2022-08-06T18:55:26Z","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1178/galley/917/download/"}]}