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Case report
Mechanical thrombectomy for acute stroke in childhood: how much does restricted diffusion matter?
  1. Travis R Ladner1,
  2. Lucy He1,
  3. Lori C Jordan2,
  4. Calvin Cooper1,
  5. Michael T Froehler3,
  6. J Mocco1
  1. 1Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA
  2. 2Division of Neurology, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA
  3. 3Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Travis R Ladner, Department of Neurosurgery, Vanderbilt University, Nashville, TN 37232-2380, USA; travis.r.ladner{at}vanderbilt.edu,

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).

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