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Case Reports
. 2022 Feb 22:12:790486.
doi: 10.3389/fneur.2021.790486. eCollection 2021.

Case Report: Successful Mechanical Thrombectomy in a Newborn With Basilar Artery Occlusion

Christian Paul Stracke  1   2 , Lukas Meyer  2 , Wolfram Schwindt  1 , Alexander Ranft  3 , Ronald Straeter  4
Affiliations
Case Reports

Case Report: Successful Mechanical Thrombectomy in a Newborn With Basilar Artery Occlusion

Christian Paul Stracke et al. Front Neurol. .

Abstract

Background: Neonatal stroke remains a rare condition that has not yet been assessed in the field of endovascular treatment.

Case: We present the first case report of a successful mechanical thrombectomy in a newborn with a basilar occlusion the treatment was 14 hours after birth. Complete reperfusion of the basilar artery was achieved after the two thrombectomy maneuvers with stent retrievers. Imaging follow-up proved patency of the target vessel and at day 30, the patient showed no neurologic deficits.

Conclusions: Mechanical thrombectomy appears to be technically feasible and can be an individual option in selected cases to treat stroke in neonates with proven persistent proximal cerebral artery occlusion.

Keywords: basilar; neonatal stroke; newborn; pediatric; stroke; thrombectomy.

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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.

Figures

Figure 1
Figure 1
Magnetic resonance imaging (MRI) before intervention. (a,b) TOF shows the stop of flow signal in the distal basilar artery (arrow in a and double arrow in (b), and a discontinuous flow signal in the proximal basilar artery (arrowheads); (c) diffusion-weighted imaging (DWI) MRI signal elevation and ADC decrease (d) in the cerebellum corresponding to SCA territory without significant FLAIR changes (e). Only small diffusion restriction in the brain stem (medulla oblongata).
Figure 2
Figure 2
(a) Initial finding of distal basilar artery occlusion (arrow); (b) super selective injection into left PCA; (c) proximal occlusion after the 1st retriever maneuver (open arrow); (d) deployment of Preset device (white arrowheads); (e) finding after the 2nd retrieval with vasospasm (black arrowheads); and (f) final control after nimodipine infusion.
Figure 3
Figure 3
(a,b) MRI on day 1, after the intervention, shows bright DWI lesions in both SCA territories with small brain stem involvement; (c) TOF proves patent hypoplastic basilar artery; (d,e) MRI on day 15 shows normalization of DWI signal and decrease in the FLAIR lesion in the cerebellum; and (f) missing proximal flow signal in left VA.
Figure 4
Figure 4
Three months following up of MRI and MRA. Postischemic defects in bilateral SCA territory with focal atrophy in the cerebellum on the following: (a) FLAIR (white arrow); (b,c) T2w (black arrows), proximal vertebral artery shows no antegrade flow in v0-V2 with distal reperfusion; (d,e) white double arrows; and (f) the basilar artery shows normal flow signal.
See this image and copyright information in PMC

References

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