CASE REPORT
Year : 2018  |  Volume : 9  |  Issue : 1  |  Page : 90-92

Unilateral transient watershed cerebral infarct in a 6-year-old girl with frequently relapsing nephrotic syndrome


Department of Pediatrics, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India

Correspondence Address:
Jaya Shankar Kaushik
Department of Pediatrics, Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak - 124 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jnsbm.JNSBM_133_17

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Nephrotic syndrome is a prothrombotic state with predisposition to venous sinus thrombosis and arterial vascular stroke. Watershed infarcts in junction of arterial territory develop in hypotensive hypovolemic state. These border zone infarcts are usually bilateral in the absence of unilateral arterial stenosis or microembolism. We report a 6-year-girl of frequently relapsing nephrotic syndrome who developed sudden onset hemiparesis with aphasia. Magnetic resonance (MR) imaging brain revealed unilateral watershed infarct in territory between the major cerebral arterial vessels with evidence of restricted diffusion and normal vessel anatomy on MR angiography. This could possibly reflect asymmetric variant of posterior reversible encephalopathy syndrome that resolved with remission on steroids.


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