Successful Treatment of Recurrent Basilar Artery Occlusion with Intra-Arterial Thrombolysis and Vertebral Artery Coiling in a Child

Successful Treatment of Recurrent Basilar Artery Occlusion with Intra-Arterial Thrombolysis and Vertebral Artery Coiling in a Child

Abstract
Background Signs of brainstem ischemia in children may be subtle, and outcome following basilar artery occlusion is often poor. There
currently are no guidelines in children regarding the best methods to diagnose and treat basilar artery occlusion.

Methods Case report and literature review.

Results We describe the presentation and management of recurrent basilar artery occlusion in a previously healthy 5-year-old boy with
vertebral artery dissection. Treatment included emergent intra-arterial tPA and mechanical thrombolysis of basilar artery
clot, followed by later coiling of the vertebral artery to prevent recurring episodes of basilar artery ischemia.

Conclusion Management of brainstem stroke in children requires coordination of neurology, critical care, and interventional radiology
services. Delayed intra-arterial thrombolysis and vertebral artery coiling can be successfully used to treat basilar artery
occlusion and prevent the recurrence of brainstem ischemia in children .

Content Type Journal Article Pages 1-5 DOI 10.1007/s12028-011-9579-7 Authors
John Condie, Department of Pediatrics, Division of Neurology, Northwestern University Feinberg School of Medicine, No. 51, Children’s Memorial Hospital, 2300 Children’s Plaza, Chicago, IL 60614-3394, USA Ali Shaibani, Departments of Radiology and Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Mark S. Wainwright, Department of Pediatrics, Divisions of Neurology and Critical Care Medicine, Northwestern University Feinberg School of Medicine, No. 51, Children’s Memorial Hospital, 2300 Children’s Plaza, Chicago, IL 60614-3394, USA

Journal Neurocritical Care Online ISSN 1556-0961 Print ISSN 1541-6933

http://www.springerlink.com/content/v8466g2618242558/



Categories: Vascular

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