Related Experiment Video
Updated: Apr 21, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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.
Insights
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.
Abstract:
Mechanical thrombectomy holds promise for children with large cerebral arterial occlusions, although there are few reports in this population. We report a case of retrievable stent-assisted mechanical thrombectomy in a 5-year-old with basilar artery occlusion, despite late presentation and extensive initial diffusion-weighted imaging (DWI) restriction. This resulted in successful Thrombolysis in Cerebral Infarction 2B reperfusion and excellent clinical outcome. At 6-week follow-up he was completely back to baseline with no residual deficits (pediatric stroke outcome measure=0, modified Rankin scale=0). At 3-month follow-up the patient has not had any recurrent stroke or concern for stroke-like symptoms. We review the literature on mechanical thrombectomy and DWI changes in acute stroke in early to middle childhood (<12 years old).
