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Updated: May 26, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
CT perfusion guided delayed recanalization with favorable outcome in pediatric stroke
Andrew Xavier1, Amit Kansara, Aniel Q Majjhoo
1Department of Neurological Surgery, Wayne State University, Detroit, Michigan 48201, USA. axavier@med.wayne.edu
Insights
Mechanical thrombectomy successfully treated acute ischemic stroke in a pediatric patient with internal carotid artery occlusion. This approach may benefit select pediatric stroke cases with large vessel occlusions.
Area of Science:
- Neurology
- Interventional Neurology
- Pediatric Stroke
Background:
- Acute ischemic stroke in children lacks approved treatments.
- Large intracranial arterial occlusions present a significant challenge in pediatric stroke management.
Observation:
- A 16-year-old male presented with acute left-sided weakness and right internal carotid artery occlusion.
- CT perfusion revealed a substantial penumbra in the right middle cerebral artery territory.
Findings:
- Successful recanalization was achieved using a self-expanding stent and mechanical thrombectomy.
- Post-procedure imaging confirmed resolution of the penumbra, with excellent functional recovery at 1 year (modified Rankin Scale score of 0).
Implications:
- Mechanical thrombectomy is a viable treatment option for select pediatric acute ischemic stroke patients with large vessel occlusions.
- This case highlights the potential for endovascular therapy in improving outcomes for pediatric stroke.
- Further research is warranted to define the optimal patient population and treatment protocols for mechanical thrombectomy in pediatric stroke.
Abstract:
There are no approved treatment options for acute ischemic stroke in the pediatric population. A case is presented of a 16-year-old boy with acute left-sided weakness who was transferred to our institution on the third day after onset of symptoms and after deterioration in his condition. He had right internal carotid artery occlusion beyond the origin of the ophthalmic artery. CT perfusion study showed a large area of penumbra in the right middle cerebral artery distribution. Recanalization was achieved with self-expanding stent placement and mechanical thrombectomy. Post procedure CT perfusion study showed resolution of the penumbra. At the 3 month follow-up, his modified Rankin Scale score was 1 and at 1 year it was 0. A subset of pediatric patients with acute ischemic stroke secondary to large intracranial arterial occlusion may be potential candidates for this treatment approach.