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Korean J Crit Care Med > Volume 28(2); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(2): 119-122. doi: https://doi.org/10.4266/kjccm.2013.28.2.119
급성 심근염을 치료중이던 영아에서 발생한 뇌경색
이 가 현ㆍ김 여 향
계명대학교 의과대학 소아과학교실
Cerebral Ischemic Stroke in an Infant with Acute Myocarditis: A Case Report
Ga Hyun Lee, Yeo Hyang Kim
Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea. kimyhped@hanmail.net
A 9-month-old infant presented with cough, tachypnea, and grunting was admitted. The patient was revealed to have cardiomegaly, high NT-proBNP, and severe left ventricular dilation and dysfunction; she was subsequently diagnosed with acute myocarditis and congestive heart failure. Intravenous immunoglobulin, inotropics, diuretics, angiotensin converting enzyme inhibitors and beta blocker were used. However, left hemiparesis suddenly developed at 30-day after treatment. Brain MRI showed high signal intensity in the right middle cerebral arterial territory on diffusion weighted brain MRI and in the left parietal lobe with gyral enhancement. Echocardiogram revealed no definite intraventricular thrombus. The patient was started on an antiplatelet agent only without anticoagulant therapy for the treatment of cerebral infarct in respect of the risk to the infant. Four years after the cerebral ischemic stroke (CIS), she showed complete recovery from hemiparesis, with no more CIS. In conclusion, severe ventricular dilatation and dysfunction can lead to thromboembolic events in infants. We should keep in mind that anticoagulant or antiplatelet agents can be used in specific situations.
Key Words: infant; myocarditis; stroke
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