A Pediatric Aortic Dissection with Cerebral Bleed: A Review in Diagnosis and Management

Cameron Sd

doi:10.4172/2155-9864.1000144

Abstract

Trauma in children is major cause of morbidity and mortality and motor vehicle accident (MVA) is the most common cause of blunt trauma. Often times multiple organ systems are affected in MVA e.g. chest injury accompanied by head injury or abdominal visceral rupture. Thoracic vascular injury is rare in children but can prove life threatening if not treated promptly. The diagnosis of such injuries poses a challenge and sometimes different diagnostic modalities could show contradicting diagnosis. In such a situation it may be prudent to do further investigation with another modality; but clinical condition has to be taken into consideration.

Highlights

One-third of all hospital admissions in the U.S are trauma-related
The National Pediatric Trauma Registry reports that 40% of cases are a result of motor vehicle accidents (MVA); other common causes include bicycle injuries and falls [1]
Computed tomography (CT) of the brain showed a right temporal middle fossa parenchymal bleed; CT angiogram (CTA) of the chest was read as a Stanford type A aortic dissection with extension into the proximal innominate and left common carotid arteries (Figure 1 and 2)

Summary

Introduction

One-third of all hospital admissions in the U.S are trauma-related. Trauma is major source of morbidity and mortality in children. The National Pediatric Trauma Registry reports that 40% of cases are a result of motor vehicle accidents (MVA); other common causes include bicycle injuries and falls [1]. Pulmonary contusions are the most common injury seen in pediatric blunt chest trauma patients [5] and may lead to bleeding, edema, airway obstruction, impaired ventilation &perfusion, and hypoxia [3]. This differs from the adult population, in whom pneumothorax, hemothorax and rib fractures are more common from blunt chest injury [6]. Rare pediatric chest injuries include diaphragm rupture, heart contusions, flail chest, tracheobronchial disruption, great vessel injury, and esophageal rupture [5]

Case Study

Findings

Discussion