open access

Vol 27, No 3 (2023)
Case report
Published online: 2023-07-24
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Ischemic stroke and hypertension in a child — a case report of two patients

Jan Koziej12, Krzysztof Skoczyński12, Michał Pac1, Łukasz Obrycki1, Mieczysław Litwin1
·
Arterial Hypertension 2023;27(3):176-188.
Affiliations
  1. Department of Nephrology, Kidney Transplantation and Hypertension, Children`s Memorial Health Institute, Warsaw, Poland
  2. Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland

open access

Vol 27, No 3 (2023)
CASE REPORT
Published online: 2023-07-24

Abstract

Ischemic stroke is a rare condition in children and is typically a complication of systemic diseases, such as congenital or acquired arterial diseases. The article discusses cases of two patients: a 2.5-year-old girl and a 3.5-year-old boy with ischemic stroke, severe hypertension and with multiple medium-caliber arterial stenosis involving the intracranial segments of the carotid arteries and renal arteries stenoses. Medical imaging showed a developed collateral circulation in the central nervous system typical of moyamoya disease. Molecular confirmation of the RNF213 gene variant was obtained in one patient. Complex drug treatment managed to achieve normotension. In further observation, the development of stenosis in medium-caliber arteries, including the pulmonary vascular bed, was observed. Presented cases show the evolution of vascular alterations in a patient with molecularly confirmed moyamoya disease and in a patient with a similar clinical phenotype without molecular confirmation.

Abstract

Ischemic stroke is a rare condition in children and is typically a complication of systemic diseases, such as congenital or acquired arterial diseases. The article discusses cases of two patients: a 2.5-year-old girl and a 3.5-year-old boy with ischemic stroke, severe hypertension and with multiple medium-caliber arterial stenosis involving the intracranial segments of the carotid arteries and renal arteries stenoses. Medical imaging showed a developed collateral circulation in the central nervous system typical of moyamoya disease. Molecular confirmation of the RNF213 gene variant was obtained in one patient. Complex drug treatment managed to achieve normotension. In further observation, the development of stenosis in medium-caliber arteries, including the pulmonary vascular bed, was observed. Presented cases show the evolution of vascular alterations in a patient with molecularly confirmed moyamoya disease and in a patient with a similar clinical phenotype without molecular confirmation.

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Keywords

hypertension; moyamoya disease; ischemic stroke

About this article
Title

Ischemic stroke and hypertension in a child — a case report of two patients

Journal

Arterial Hypertension

Issue

Vol 27, No 3 (2023)

Article type

Case report

Pages

176-188

Published online

2023-07-24

Page views

458

Article views/downloads

300

DOI

10.5603/AH.a2023.0017

Bibliographic record

Arterial Hypertension 2023;27(3):176-188.

Keywords

hypertension
moyamoya disease
ischemic stroke

Authors

Jan Koziej
Krzysztof Skoczyński
Michał Pac
Łukasz Obrycki
Mieczysław Litwin

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