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Acute Ischemic Pediatric Stroke Management: An Extended Window for Mechanical Thrombectomy?
Ashish Kulhari1,2, Elizabeth Dorn3, Jonathan Pace1,2
1Department of Neurology, Neurological Institute, University Hospitals, Cleveland, OH, United States.
Frontiers in Neurology
|December 15, 2017
Summary
Pediatric ischemic stroke is rare, but this 9-year-old boy with restrictive cardiomyopathy successfully underwent mechanical thrombectomy. This case suggests acute stroke therapies like mechanical thrombectomy may be safe for carefully selected children.
Area of Science:
- Neurology
- Pediatric Cardiology
Background:
- Ischemic stroke is uncommon in children.
- Congenital cardiomyopathy is a potential cause of pediatric stroke.
- There is a lack of pediatric-specific guidelines for acute stroke treatment.
Observation:
- A 9-year-old boy presented with a right middle cerebral artery ischemic stroke.
- The stroke was secondary to primary restrictive cardiomyopathy.
- The patient had a small infarct core and a large penumbra.
Findings:
- The child met adult criteria for mechanical thrombectomy due to the infarct characteristics.
- Mechanical thrombectomy, combined with thrombolysis, was considered safe for this patient.
- Literature suggests potential benefits of mechanical thrombectomy in select pediatric stroke cases.
Implications:
- This case highlights the potential safety and efficacy of mechanical thrombectomy in pediatric ischemic stroke.
- It underscores the importance of considering advanced stroke therapies in children, even without specific pediatric guidelines.
- Further research into mechanical thrombectomy for pediatric stroke is warranted.
