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A 13-year-old boy with no medical history presented with bifrontal headache, right brachiofacial paresthesias and disorientation. In the preceding weeks, he had experienced intermittent headache worsened by exertion. The patient had no associated aura. Examination revealed disorientation, dyslalia, ideomotor apraxia, sensory aphasia, bradypsychia, gait instability and deviation of the facial commissure. An urgent MRI was requested, which showed generalised hypoperfusion of the left hemisphere in the arterial spin labelling sequence and a prominence of left venous structures related to deoxygenation on the susceptibility weighted imaging (SWI) sequence …
Contributors JAM, NGR and TCG—conceptualisation and study design; literature search and selection, data curation and extraction, formal analysis; investigation; methodology; project administration; resources; validation; visualisation; writing (original draft); writing (review and editing). AILdM, RAPB, BEA and DMP-F—resources; validation; visualisation; writing (review and editing).
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.