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Nasr N, Delamarre L, Cheuret E, et al. Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child. Front Neurol. 2021;12:670565doi: 10.3389/fneur.2021.670565.
Nasr, N., Delamarre, L., Cheuret, E., Chausseray, G., Olivot, J. M., Acar, P., & Bonneville, F. (2021). Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child. Frontiers in neurology, 12670565. https://doi.org/10.3389/fneur.2021.670565
Nasr, Nathalie, et al. "Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child." Frontiers in neurology vol. 12 (2021): 670565. doi: https://doi.org/10.3389/fneur.2021.670565
Nasr N, Delamarre L, Cheuret E, Chausseray G, Olivot JM, Acar P, Bonneville F. Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child. Front Neurol. 2021 May 28;12:670565. doi: 10.3389/fneur.2021.670565. eCollection 2021. PMID: 34122315; PMCID: PMC8193682.
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Front Neurol. 2021 May 28;12:670565. doi: 10.3389/fneur.2021.670565. eCollection 2021.

Case Report: Late Successful Thrombectomy for Ischemic Stroke in a 2-Year-Old Child.

Frontiers in neurology

Nathalie Nasr, Louis Delamarre, Emmanuel Cheuret, Gerald Chausseray, Jean Marc Olivot, Philippe Acar, Fabrice Bonneville

Affiliations

  1. Department of Neurology, Toulouse University Hospital, Université Toulouse III, INSERM UMR 1048, Toulouse, France.
  2. Department of Anesthesiology and Intensive Care, Toulouse University Hospital, Toulouse, France.
  3. Department of Pediatry, Pediatric Neurology Unit, Toulouse University Hospital, Toulouse, France.
  4. Department of Neurology, Toulouse University Hospital, Université Toulouse III, Toulouse, France.
  5. Department of Pediatry, Pediatric Cardiology Unit, Toulouse University Hospital, Université Toulouse III, Toulouse, France.
  6. Department of Neuroradiology, Toulouse University Hospital, Université Toulouse III, Toulouse, France.

PMID: 34122315 PMCID: PMC8193682 DOI: 10.3389/fneur.2021.670565

Abstract

Despite extensive evidence of benefit of thrombectomy in adult ischemic stroke due to large-vessel occlusion in the 6-h window, its role remains uncertain in very young children. We describe hereafter the case of a 2-year-old female child who had a successful thrombectomy 9 h after stroke onset. The patient presented with right hemiplegia, central facial palsy, a normal level of consciousness, and speech difficulties. The PedNIHS score was 11. CT scan without contrast injection displayed spontaneous hyperdensity of the middle cerebral artery (MCA), with only limited early signs of ischemia (ASPECTS 8). CT angiography demonstrated occlusion of the proximal MCA with good collaterals. Thrombectomy was realized. Complete recanalization (TICI 3) was obtained under general anesthesia after two passes of a stent retriever. Time from symptoms onset to full recanalization was 9 h. The acute ischemic stroke was caused by embolic thrombus from a congenital heart disease. Clinical recovery was complete. Three months after the thrombectomy, the young patient was doing well without any neurological sequelae (PedNIHSS 0; modified Rankin Scale: 0). This case report is an example of a decision-making process to perform thrombectomy in a very young child, which included cardio-embolic etiology as a parameter that potentially might have participated to the successful outcome of the therapeutic procedure.

Copyright © 2021 Nasr, Delamarre, Cheuret, Chausseray, Olivot, Acar and Bonneville.

Keywords: acute stroke; child; congenital heart disease; ischemic stroke; thrombectomy

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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