Neurocritical Care

, Volume 16, Issue 1, pp 158–162

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

Practical Pearl

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.

Keywords

Brainstem stroke Thrombolysis Dissection Coiling Top of the basilar syndrome 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • John Condie
    • 1
  • Ali Shaibani
    • 3
  • Mark S. Wainwright
    • 2
  1. 1.Department of Pediatrics, Division of NeurologyNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Department of Pediatrics, Divisions of Neurology and Critical Care MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Departments of Radiology and NeurosurgeryNorthwestern University Feinberg School of MedicineChicagoUSA

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