A 20-month-old girl when falling from her couch, hit her head on a coffee table and then become sleepy. Parents reported no history of epistaxis, hematuria, hematochezia, or melena. They witnessed no seizure activity and state that she is not a particularly clumsy child. The patient was born at 41 weeks by induced vaginal delivery with a birthweight of 4.2 kg and Apgar scores of 9 at 1 min and 10 at 5 min. Her development has been normal.
However, the mother’s pregnancy, labor, and delivery were significant for borderline hypertension. Past Medical History A choroid plexus cyst had been noted in the child in utero. Family history A paternal aunt who underwent surgery to remove some bleeding around her brain. A paternal grandmother who suffered a hemorrhagic stroke at the age of 35 years. Physical examination Alert and very acute Growth parameters were normal No cutaneous vascular skin…
