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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Mechanical thrombectomy for acute stroke in childhood: how much does restricted diffusion matter?
Travis R Ladner1, Lucy He1, Lori C Jordan2
1Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
BMJ Case Reports
|November 14, 2014
Summary
Mechanical thrombectomy successfully treated a 5-year-old
Area of Science:
- Pediatric Neurology
- Interventional Neuroradiology
- Cerebrovascular Diseases
Background:
- Large cerebral arterial occlusions (LCAO) in children are rare but serious.
- Mechanical thrombectomy is an emerging treatment for acute ischemic stroke in pediatric patients.
- Limited data exists on mechanical thrombectomy for pediatric basilar artery occlusion (BAO).
Observation:
- A 5-year-old presented with acute basilar artery occlusion.
- The patient had a late presentation with extensive diffusion-weighted imaging (DWI) restriction.
- Retrievable stent-assisted mechanical thrombectomy was performed.
Findings:
- Successful Thrombolysis in Cerebral Infarction (TICI) 2B reperfusion was achieved.
- The patient experienced an excellent clinical outcome with no residual deficits at 6 weeks.
- No recurrent stroke or stroke-like symptoms were observed at 3-month follow-up.
Implications:
- Mechanical thrombectomy is a viable treatment option for pediatric BAO, even in late presentations with significant DWI changes.
- This case highlights the potential for excellent functional recovery in children undergoing mechanical thrombectomy for acute ischemic stroke.
- Further research is warranted to establish guidelines for mechanical thrombectomy in pediatric stroke populations.
