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Updated: Apr 20, 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 is a promising treatment for pediatric large cerebral arterial occlusions. A 5-year-old achieved excellent recovery after stent-assisted mechanical thrombectomy for basilar artery occlusion.
Area of Science:
- Neurology
- Pediatric Stroke
- Interventional Neuroradiology
Background:
- Large cerebral arterial occlusions (LCAOs) in children are rare but can lead to severe disability.
- Mechanical thrombectomy (MT) is an established treatment for acute ischemic stroke in adults, but data in pediatric populations are limited.
- Early reperfusion is critical for improving outcomes in acute ischemic stroke.
Observation:
- A 5-year-old presented with a basilar artery occlusion (BAO) with extensive diffusion-weighted imaging (DWI) restriction.
- The patient underwent successful retrievable stent-assisted mechanical thrombectomy.
- Successful reperfusion (Thrombolysis in Cerebral Infarction 2B) was achieved despite a late presentation.
Findings:
- The patient experienced an excellent clinical outcome with no residual deficits at 6-week follow-up (pediatric stroke outcome measure=0, modified Rankin scale=0).
- No recurrent stroke or stroke-like symptoms were reported at 3-month follow-up.
- This case highlights the potential efficacy of MT in pediatric stroke.
Implications:
- Mechanical thrombectomy is a viable and effective treatment option for children with basilar artery occlusion and LCAO.
- Further research and case reports are needed to establish MT guidelines for pediatric stroke.
- Successful MT in pediatric stroke can lead to complete functional recovery and improved long-term outcomes.
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).
