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Importance of the arc of Riolan in children with severe middle aortic syndrome
  1. Zainab Arslan1,
  2. Premal Amrishkumar A Patel2,
  3. Kishore Minhas2,
  4. Kjell Tullus1,
  5. Jelena Stojanovic1
  1. 1Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  2. 2Interventional Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  1. Correspondence to Dr Jelena Stojanovic, Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Jelena.Stojanovic{at}doctors.org.uk

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A previously healthy 4-year-old girl presented to the emergency department with history of acute-onset right arm weakness, ataxia and slurred speech. Symptoms resolved within a few hours and she was discharged. Three days later, she represented with left arm weakness. Systolic blood pressures (BPs) of 240 and 168 mm Hg were measured in the upper and lower limbs, respectively.

MRI of the brain revealed acute right frontal cortex and old midbrain infarcts. Abdominal …

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Footnotes

  • Twitter @Zainab_arslan_, @Premal__Patel, @kish_minhas, @@dr_JelaS

  • Contributors ZA conceived, wrote and reviewed the article. PAAP, KT and JS wrote and reviewed the article. KM reviewed the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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