Purpose or Case Report: Pediatric stroke is a relatively rare disease, but remains one of the most common causes of death in childhood.
A higher homocysteine level raises the risk of vascular disease, including stroke.
In the setting of heavy alcohol consumption, the risk for all major types of strokes is increased, especially those of ischemic etiology.
A 17-year-old boy who had used a large amount of cigarettes and alcohol the previous evening, presented to our clinic. Upon admission, the patient’s condition was critical, with impaired consciousness. Left-sided facial nerve paresis and left-sided hemiparesis were observed. An CT examination of the brain was performed, no gross changes were found and was indicates an urgent MRI. On MRI there was irregular configuration of the dorsal posterior limb of the internal capsule and ventrolateral parts of the right thalamus, with a focus of diffusion restriction and increased MR signal intensity on T2-weighted FLAIR sequences. MR findings are consistent with an acute ischemic stroke in the territory of the right anterior choroidal artery. No neurological deficits were detected after treatment.
Alcohol intoxication and hyperhomocysteinemia are significant risk factors for ischemia.
The combination of hyperhomocysteinemia with alcohol and nicotine abuse presents an even higher and more persistent risk for ischemia.
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