Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.
BMJ Case Rep. 2021 May 31;14(5):e017464. doi: 10.1136/bcr-2021-017464.
Arterial dissection is an uncommon cause of paediatric stroke. Medical therapy remains first-line for treatment. There are few reports of neurovascular stents for paediatric intracranial arterial dissection. Two adolescents presented with neurological deficits and CT angiography concerning for supraclinoid internal carotid artery stenosis. The diagnosis of dissection was secured through a combination of vessel wall MRI and digital subtraction angiography. The patients experienced progressive ischaemic symptoms, despite medical management including anticoagulation, and required stenting. The stents used were a Neuroform EZ and an Atlas. Both patients recovered to Modified Rankin Scale (mRS) 0 and had restored vessel calibre on 6-month follow-up digital subtraction angiography. Neurovascular stents can be used to treat progressively symptomatic intracranial arterial dissections in the paediatric population if medical therapy fails.
动脉夹层是儿童中风的一个不常见原因。医学治疗仍然是治疗的首选方法。对于儿童颅内动脉夹层,很少有关于神经血管支架的报道。两名青少年出现神经功能缺损,CT 血管造影提示颈内动脉虹吸段狭窄。通过血管壁 MRI 和数字减影血管造影相结合的方式确诊为夹层。尽管进行了包括抗凝在内的药物治疗,两名患者仍出现进行性缺血症状,需要进行支架置入。使用的支架为 Neuroform EZ 和 Atlas。两名患者均恢复至改良 Rankin 量表(mRS)0 分,6 个月的数字减影血管造影随访显示血管口径恢复正常。如果药物治疗失败,神经血管支架可用于治疗儿童进行性症状性颅内动脉夹层。