title: Clinically successful late recanalization of basilar artery occlusion in childhood: what are the odds? Case report and review of the literature.
abstract: OBJECTIVE
  Acute basilar artery occlusion is an infrequent but potentially fatal cause of stroke, both in adults and children. We present our experience with a 6-year-old child and we investigate the rationality for late treatment of acute basilar occlusion in children.
  
  
  METHODS
  We report the case of a 6-year-old boy with acute basilar artery occlusion presented with a full blown locked-in syndrome, admitted to the endovascular suite 44 h after the stroke onset, and we review all the reported cases of basilar artery occlusions presented with locked-in syndrome in children.
  
  
  RESULTS
  Six hours following admission the basilar artery was partially recanalized by intra-arterial thrombolysis combined with mechanical clot angioplasty. After 12 h, the patient was awake, oriented, his speech function was fully restored and he had only a mild right hemiparesis that recovered completely after a month.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of complete clinical recovery after delayed (50 h) endovascular recanalization of basilar artery in a child. Intra-arterial thrombolysis combined with cerebral angioplasty, can successfully restore the patency of the basilar artery and the neurologic deficit of children with acute basilar artery occlusion, even after a considerable delay.
authors.affiliation: Hadassah Stroke Center, Hadassah University Hospital, Jerusalem, Israel. neurosavas@yahoo.gr
authors.forename: Savvas
authors.initials: S
authors.lastname: Grigoriadis
authors.forename: John Mose
authors.initials: JM
authors.lastname: Gomori
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Grigoriadis
authors.forename: José E
authors.initials: JE
authors.lastname: Cohen
mesh_terms: D000367:Age Factors; D000800:Angioplasty, Balloon / Q000379:methods* / Q000639:trends; D000925:Anticoagulants / Q000008:administration & dosage; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020526:Brain Stem Infarctions / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D002648:Child; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011149:Pons / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D011782:Quadriplegia / Q000209:etiology / Q000473:pathology / Q000628:therapy; D011859:Radiography; D015912:Thrombolytic Therapy / Q000379:methods* / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000473:pathology / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator