Journal of Pediatric Neurology 2022; 20(04): 291-295
DOI: 10.1055/s-0041-1739261
Case Report

Aortic Thrombus Embolization in A Patient with Tuberous Sclerosis

Steven Wolf
1   Division of Child Neurology, Department of Pediatrics, New York Medical College, Valhalla, New York, United States
,
1   Division of Child Neurology, Department of Pediatrics, New York Medical College, Valhalla, New York, United States
,
William Gomes
2   Division of Neuroradiology, Department of Radiology, Westchester Medical Center, Valhalla, New York, United States
,
Philip Overby
1   Division of Child Neurology, Department of Pediatrics, New York Medical College, Valhalla, New York, United States
,
Patricia McGoldrick
1   Division of Child Neurology, Department of Pediatrics, New York Medical College, Valhalla, New York, United States
› Author Affiliations

Abstract

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder affecting many organ systems. Patients commonly develop a variety of benign tumors as well as neurological disease, including seizures, autism, and cognitive delay. We report here the case of an adolescent patient with TSC and a history of mild COVID-19 who presented with a 1-day history of altered mental status. The patient was found to have ischemic cerebral infarction of the right MCA and ACA territories. Initial angiography showed an occlusion of the right internal carotid artery without a demonstrable etiology, with follow-up echocardiography and angiography revealing a large aortic thrombus. The patient was not a candidate for thrombus removal due to her cerebral infarct and received medical anticoagulation. Thrombosis progressed to involve the left ICA, with left cerebral infarction and subsequent death. Aortic thrombus embolization as a cause of cerebrovascular accident (CVA) is a novel finding in the setting of TSC and should be considered for pediatric patients with CVA of unknown etiology. It is unclear whether this was related to the prior COVID-19 infection.



Publication History

Received: 04 August 2021

Accepted: 18 September 2021

Article published online:
03 December 2021

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