A case of carotid artery dissection suggesting ADEM

Abstract

We present a case of a boy with recurrent left-sided hemiparesis. Early magnetic resonance imaging showed features suggesting acute disseminated encephalomyelitis (ADEM). However, he deteriorated neurologically on high dose methylprednisolone. A follow-up cerebral magnetic resonance imaging showed an extensive infarction due to carotid artery dissection. Distinguishing features between ADEM and acute stroke in childhood are described, but at early stage, it might be difficult to distinguish ADEM from acute stroke.