Clinically successful late recanalization of basilar artery occlusion in childhood: what are the odds? Case report and review of the literature.
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.
Grigoriadis
Savvas
S
Hadassah Stroke Center, Hadassah University Hospital, Jerusalem, Israel. neurosavas@yahoo.gr
Gomori
John Mose
JM
Grigoriadis
Nikolaos
N
Cohen
José E
JE
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*
D000925:Anticoagulants; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator