Stroke by carotid artery complete occlusion in Kawasaki disease: case report and review of literature

Pediatr Neurol. 2013 Dec;49(6):469-73. doi: 10.1016/j.pediatrneurol.2013.08.011. Epub 2013 Oct 3.

Abstract

Background: Kawasaki disease is an acute and time-limited systemic vasculitis primarily affecting young children.

Patient: We describe an 18-month-old girl with Kawasaki disease who developed cerebral infarction following complete occlusion of her right internal carotid artery.

Results: The occlusion occurred 10 days after the onset of fever, while she was on high-dose aspirin, and the day after she received intravenous immunoglobulin treatment. We present the first literature review on this very rare complication.

Conclusion: Stroke is a rare neurological complication in Kawasaki disease. Optimal treatment should be begun as soon as possible after diagnosis. Intravenous immunoglobulins seem to reduce the cerebrovascular complications, but evaluation of hydration status is strongly recommended before performing such treatment.

Keywords: Kawasaki disease; carotid artery occlusion; immunoglobulin; infant; stroke.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Carotid Artery, Internal / pathology*
  • Carotid Stenosis / complications*
  • Cerebral Infarction / etiology
  • Circle of Willis / diagnostic imaging
  • Databases, Bibliographic / statistics & numerical data
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Infant
  • Magnetic Resonance Angiography
  • Mucocutaneous Lymph Node Syndrome / complications*
  • Radiography
  • Stroke / etiology*