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Stents for progressively symptomatic paediatric intracranial arterial dissection
Catherine R G Jay1, Aubrey N Duncan2, Shehanaz K Ellika3
1Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
BMJ Case Reports
|June 1, 2021
Summary
Neurovascular stents offer a viable treatment for paediatric stroke caused by intracranial arterial dissection when medical therapy fails. This approach successfully restored vessel function and improved outcomes in two adolescent patients.
Area of Science:
- Neuroendovascular interventions
- Paediatric neurology
- Vascular imaging
Background:
- Arterial dissection is a rare cause of stroke in children.
- Current first-line treatment involves medical management.
- Limited data exists on neurovascular stenting for paediatric intracranial arterial dissection.
Observation:
- Two adolescents presented with neurological deficits suggestive of internal carotid artery stenosis.
- Diagnosis was confirmed using vessel wall MRI and digital subtraction angiography.
- Patients showed progressive ischemic symptoms despite anticoagulation therapy.
Findings:
- Endovascular stenting was performed using Neuroform EZ and Atlas stents.
- Both patients achieved a Modified Rankin Scale score of 0 post-procedure.
- Follow-up angiography at 6 months showed restored vessel caliber.
Implications:
- Neurovascular stenting is a safe and effective option for pediatric intracranial arterial dissection when medical management is insufficient.
- This case series expands treatment options for pediatric stroke due to arterial dissection.
- Further research into neurovascular stenting for pediatric cerebrovascular diseases is warranted.
