Placement of Endovascular Stent for Reperfusion of Cerebral Infarct After Pediatric Traumatic Internal Carotid Artery Dissection

Authors

Arthur Rezayev Department of Neurosurgery, University of Arkansas for Medical Sciences, USA, Department of Neurosurgery, Arkansas Children’s Hospital, 1 Children’s Way, USA.
William S Coggins Department of Neurosurgery, University of Arkansas for Medical Sciences, USA, Department of Neurosurgery, Arkansas Children’s Hospital, 1 Children’s Way, USA.
Adewumi Amole Department of Interventional Radiology, Baptist Health, USA
Mudassar Kamran Department of Interventional Radiology, University of Arkansas for Medical Sciences, USA
Tomoko Tanaka Department of 1Department of Neurosurgery, University of Arkansas for Medical Sciences, USA, Department of Neurosurgery, Arkansas Children’s Hospital, 1 Children’s Way, USANeurosurgery, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205 2 Department of Neurosurgery, Arkansas Children’s Hospital, 1 Children’s Way, Little Rock, AR 72202

DOI:

https://doi.org/10.3941/jrcr.v18i1.5217

Abstract

Background: Traumatic intracranial ICA dissections are not commonly seen in children. Dissection resulting in perfusion deficit warrants intervention. Here we encountered a patient who experienced traumatic ICA dissection, treated by endovascular stenting. Methods: A 10-year-old female presented with aphasia and right sided weakness following trauma. Imaging showed deficit in the left MCA territory without core. Further imaging showed dissection of the left supraclinoid ICA, confirmed by digital subtraction angiography. Results: A Neuroform Atlas stent was placed without complication. All dysarthria and weakness had resolved on follow-up 5 months post-stenting. Conclusions: Acute stroke symptoms in children can result in lasting deficits if not treated quickly. Medical management is regarded to be first line, depending on presentation. Endovascular stenting may provide a promising means to treat pediatric ICA dissections involving perfusion deficits and mitigate permanent ischemic changes.

10 year old female CT perfusion study axial cuts showing increased Tmax as compared to the contralateral hemisphere in the left MCA territory

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Published

2024-01-31

Issue

Vol. 18 No. 1 (2024)

Section

General Radiology

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