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

J Neurointerv Surg. 2015 Dec;7(12):e40. doi: 10.1136/neurintsurg-2014-011465.rep. Epub 2014 Nov 18.

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).

Keywords: Dissection; MRI; Pediatrics; Stroke; Thrombectomy.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Male
  • Stroke / diagnosis*
  • Stroke / etiology
  • Stroke / surgery*
  • Thrombectomy / methods*
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / diagnosis*
  • Vertebrobasilar Insufficiency / surgery*