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

Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI:10.3941/jrcr.v18i1.5217
Arthur Rezayev, William S Coggins, Adewumi Amole, Mudassar Kamran, Tomoko Tanaka
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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.

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为小儿外伤性颈内动脉夹层后的脑梗塞再灌注植入血管内支架
背景:外伤性颅内 ICA 夹层在儿童中并不常见。夹层导致灌注不足,需要进行干预。在这里,我们遇到了一位经历了外伤性 ICA 夹层的患者,她接受了血管内支架治疗:一名 10 岁女性患者在外伤后出现失语和右侧肢体无力。影像学检查显示左侧 MCA 区无核心缺损。进一步造影显示左侧锁骨上ICA夹层,数字减影血管造影证实了这一结果:结果:放置了Neuroform Atlas支架,无并发症。支架植入后 5 个月随访,所有构音障碍和乏力症状均已缓解:结论:儿童急性脑卒中症状如不尽快治疗,可导致持久的功能障碍。结论:儿童急性脑卒中症状如不尽快治疗,可导致持久的功能障碍。血管内支架置入术可能是治疗涉及灌注障碍的小儿主动脉夹层并减轻永久性缺血性改变的有效方法。
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