Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine | 2021
Acute lacunar infarct in an obese adolescent with obstructive sleep apnea.
Abstract
ABSTRACT\nObstructive sleep apnea (OSA) is associated with an increased risk of acute ischemic cerebrovascular accidents in adults. However, this association has not been well established in the pediatric population. We report a case of acute right internal capsule lacunar infarct manifesting as left-sided hemiplegia in an adolescent with severe obesity. Severe untreated OSA was identified during the hospital stay. Positive airway pressure therapy, weight loss, and tonsillectomy eventually normalized sleep-disordered breathing. The patient recovered completely without any residual neurological deficits with multidisciplinary care. Lacunar infarcts due to hypertension-related cerebral vasculopathy is a well-known cause of stroke in adults. Untreated OSA may cause hypertension and potentially predispose even the pediatric population to develop lacunar infarcts. Polysomnogram needs to be considered as a part of the diagnostic algorithm in pediatric stroke patients.