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Vertebrobasilar thrombosis in children: report of two cases and recommendations for treatment

Arno Sungarian1, John A Duncan

  • 1Department of Clinical Neurosciences, Brown Medical School, Providence, R.I. 02905, USA.

Pediatric Neurosurgery
|December 12, 2002
PubMed

Insights

High-dose intra-arterial urokinase effectively treated pediatric vertebrobasilar thrombosis (VBT) in two children, resolving neurological symptoms. Early diagnosis and intra-arterial thrombolysis are suggested for reducing childhood stroke morbidity and mortality.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Interventional Neuroradiology

Background:

  • Vertebrobasilar thrombosis (VBT) is a serious condition in children.
  • Prompt diagnosis and treatment are crucial for favorable outcomes.
  • Limited pediatric data exists on effective VBT treatments.

Observation:

  • Two pediatric patients with VBT presented with neurological deficits.
  • Both patients underwent comprehensive imaging including CT, MRI, and MR angiography.
  • Treatment involved high-dose intra-arterial urokinase within 4 hours of emergency room presentation.

Findings:

  • Complete resolution of neurological symptoms was achieved in both treated children.
  • Intra-arterial urokinase demonstrated rapid efficacy in resolving VBT.
  • No immediate complications were reported from the intervention.

Implications:

  • Early consideration of VBT in pediatric stroke evaluation is recommended.
  • Intra-arterial thrombolytic therapy, specifically urokinase, shows promise for treating pediatric VBT.
  • Further large-scale, multi-institutional studies are warranted to confirm efficacy and establish treatment guidelines for childhood stroke due to VBT.

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