Topsøe, Jakob Fink4; Sonnenborg, Laura5; Larsen, Line Lunde5; Born, Alfred Peter1; Holtmannspötter, Markus2; Kondziella, Daniel3
1 Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark2 Radiologisk Klinik, Diagnostisk Center, Rigshospitalet, The Capital Region of Denmark3 Neurologisk Klinik, Neurocentret, Rigshospitalet, The Capital Region of Denmark4 Department of Imaging and Radiology, Nordsjællands Hospital, The Capital Region of Denmark5 unknown
Basilar artery occlusion in children is rare. It has a high mortality and morbidity if recanalization is not achieved before extensive brainstem infarction has occurred. An 11-year-old boy presented with a clinical and radiological "top-of-the-basilar" syndrome. Intravenous tissue plasminogen activator was administered, and the patient was immediately referred to the regional stroke center. Subsequent mechanical thrombectomy using a Solitaire stent (Solitaire FR stent; ev3, Irvine, CA, USA) resulted in clot removal and recanalization of the basilar artery 4 hours after stroke onset. The patient made a full clinical recovery. To the authors' knowledge this is the first report on basilar artery occlusion in a child treated with "bridging" therapy, the combination of intravenous thrombolysis and endovascular thrombectomy. If the diagnosis can be made within the time window for intravenous thrombolysis (4.5 hours), the present case suggests that bridging therapy in pediatric basilar artery occlusion can be safe and effective.
Journal of Child Neurology, 2013, Vol 28, Issue 11, p. 1521-26