• Neurocritical care · Feb 2012

    Review Case Reports

    Successful treatment of recurrent basilar artery occlusion with intra-arterial thrombolysis and vertebral artery coiling in a child.

    • John Condie, Ali Shaibani, and Mark S Wainwright.
    • Department of Pediatrics, Division of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL 60614-3394, USA.
    • Neurocrit Care. 2012 Feb 1;16(1):158-62.

    BackgroundSigns 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.MethodsCase report and literature review.ResultsWe 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.ConclusionManagement 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.

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