title: A successful treatment of arterial ischemic stroke with stent insertion in a child with congenital heart disease.
abstract: BACKGROUND
  Diagnosis of arterial ischemic stroke in pediatric patients is often delayed due to the uncertainty and variability of clinical symptoms. Early diagnosis of arterial ischemic stroke can bring a favorable prognosis with prompt thrombolytic therapy or stent insertion, via transfemoral cerebral arteriogram. Acute thrombolytic therapy is rarely attempted in children because of the delayed diagnosis.
  
  
  METHODS
  We report a case of a 4-year-old girl with complex heart disease who was presented with arterial ischemic stroke at the right distal internal carotid artery and successfully treated by stent insertion in which repeated thrombolysis or ballooning had failed.
  
  
  RESULTS
  Left hemiparesis was nearly recovered 6 days after the stent insertion. The mean flow velocity of the right middle cerebral artery has slightly improved compared to that of the initial study. She has been followed-up for 6 months in the outpatient clinic without neurologic sequelae.
  
  
  CONCLUSIONS
  This case suggests that intracranial stent insertion may be a safe and an effective modality in young children, when the thrombolytic therapy or ballooning is inapplicable. Additionally, transcranial Doppler ultrasonography is useful to monitor the cerebral blood flow after stent insertion in children.
authors: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Seoul 135-710, Korea.
authors: Hee Joon
authors: HJ
authors: Yu
authors: I-Seok
authors: IS
authors: Kang
authors: Munhyang
authors: M
authors: Lee
authors: Keon-Ha
authors: KH
authors: Kim
authors: Jeehun
authors: J
authors: Lee
mesh_terms: D002343:Carotid Artery, Internal / Q000601:surgery; D002675:Child, Preschool; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D015607:Stents; D020521:Stroke / Q000150:complications* / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial