Mechanical thrombectomy for acute stroke in childhood: how much does restricted diffusion matter?

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).

• Authors: Travis R Ladner, Lucy He, Lori C Jordan, Calvin Cooper, Michael T Froehler, J Mocco
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2014 (Nov 12 2014) ISSN: 1757-790X [Electronic] England
• PMID: 25391820 (Publication Type: Case Reports, Journal Article)
• Copyright: 2014 BMJ Publishing Group Ltd.

Topics

• Basilar Artery (pathology)
• Brain (pathology)
• Child, Preschool
• Diffusion Magnetic Resonance Imaging
• Humans
• Magnetic Resonance Angiography
• Male
• Mechanical Thrombolysis
• Stroke (etiology, therapy)
• Vertebrobasilar Insufficiency (diagnosis, therapy)