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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Successful Mechanical Thrombectomy for Basilar Artery Occlusion in a Pediatric Patient: A Case Report
Agnete Teivāne1,2, Inga Naļivaiko3, Kristaps Jurjāns2,4,5
1Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia.
Insights
Endovascular treatment (EVT) shows promise for pediatric stroke, as demonstrated in a 9-year-old boy with a basilar artery thrombus. Successful EVT led to full neurological recovery, suggesting its potential in children.
Area of Science:
- Neurology
- Pediatric Stroke
- Endovascular Therapy
Background:
- Endovascular treatment (EVT) is established for adult stroke but controversial in pediatric cases.
- No current guidelines exist for EVT in children, necessitating case studies.
- Understanding EVT's risks and benefits in pediatric patients is crucial.
Observation:
- A 9-year-old male presented with acute cerebellar ischemia and a basilar artery thrombus.
- Symptoms included sudden left-sided weakness following a gastroenteritis diagnosis.
- The patient received urgent EVT 8.5 hours after symptom onset.
Findings:
- Successful revascularization was achieved through urgent EVT.
- The patient experienced improved neurological status post-treatment and rehabilitation.
- Complete neurological recovery was observed at six months, despite an unknown stroke etiology.
Implications:
- This case suggests EVT may be a viable option for pediatric basilar artery thrombosis.
- Further case reports and series are needed to establish EVT protocols for pediatric stroke.
- Pediatric patients demonstrate significant resilience and potential for recovery with timely intervention.
Abstract:
Studies have shown the benefits of endovascular treatment (EVT) in adult stroke cases, but its application in pediatric stroke remains controversial. Despite evidence of improved outcomes in adults, there are no established recommendations for EVT in children. Conducting individual case reports and case series is vital to understanding its potential advantages and disadvantages in this context. In this case report, a 9-year-old male initially diagnosed with gastroenteritis developed sudden left-sided weakness 1 day after admission. Comprehensive imaging revealed acute ischemia in the cerebellum, indicating a basilar artery thrombus. Urgent endovascular treatment (EVT) was performed 8.5 h after the onset of neurological symptoms, achieving successful revascularization. The patient underwent rehabilitation and was later discharged with improved neurological status. Despite extensive investigations, the stroke's origin remained unknown. After six months, the patient exhibited complete neurological recovery, highlighting the patient's remarkable resilience.
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