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Published on: July 9, 2020
Endovascular therapy in pediatric intracranial carotid artery dissection
Yen-Jun Lai1, Feng-Chi Chang, Chung-Jung Lin
1Department of Medical Imaging, Far Eastern Memorial Hospital, Taipei, Taiwan, Republic of China. torogerlai@gmail.com
Insights
Intracranial carotid artery dissection can cause childhood stroke. Endovascular therapy successfully treated a pediatric case with middle cerebral artery occlusion, suggesting aggressive intervention may be beneficial.
Area of Science:
- Neurology
- Pediatric Neurology
- Vascular Neurology
Background:
- Intracranial carotid dissection is an uncommon cause of stroke in children.
- Management strategies for pediatric intracranial carotid dissection remain controversial due to limited therapeutic experience.
Observation:
- A 12-year-old girl presented with an intracranial carotid artery dissection.
- The dissection led to progressive and symptomatic occlusion of the middle cerebral artery.
Findings:
- Successful endovascular treatment was achieved using intra-arterial thrombolysis and stent reconstruction.
- The intervention successfully recanalized the occluded middle cerebral artery segment.
Implications:
- This case highlights the potential efficacy of aggressive endovascular intervention in pediatric intracranial carotid dissection.
- Further research into endovascular techniques for childhood stroke secondary to carotid dissection is warranted.
Abstract:
Intracranial carotid dissection is an underrecognized cause of childhood stroke, and, in the face of limited therapeutic experience, its management is controversial. Reported here is the case of a 12-year-old girl who experienced an intracranial carotid artery dissection with progressive and symptomatic occlusion of the middle cerebral artery. Endovascular treatment with intra-arterial thrombolysis and stent reconstruction was successfully performed to recanalize the occluded arterial segment. Current management of intracranial carotid dissection in children is reviewed, with discussion of the reasons for aggressive endovascular intervention.
