title: 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.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Ladner
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: He
authors.affiliation: Division of Neurology, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Lori C
authors.initials: LC
authors.lastname: Jordan
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Calvin
authors.initials: C
authors.lastname: Cooper
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Froehler
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mocco
mesh_terms: D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*
keywords: Dissection; MRI; Pediatrics; Stroke; Thrombectomy