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New devices and techniques
Stents for progressively symptomatic paediatric intracranial arterial dissection
  1. Catherine R G Jay1,
  2. Aubrey N Duncan2,
  3. Shehanaz K Ellika3 and
  4. Matthew T Bender1
  1. 1 Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA
  2. 2 Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
  3. 3 Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
  1. Correspondence to Dr Matthew T Bender; matthew_bender{at}urmc.rochester.edu

Abstract

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.

  • CT angiography
  • stroke
  • dissection
  • stent
  • technique

https://doi.org/10.1136/bcr-2021-017464

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    Footnotes

    • Contributors MTB was the operating neurosurgeon and AND a consulting fellow for these cases. MTB proposed the case series and wrote the technical portion of the discussion. CRGJ wrote the remainder of the manuscript, with critical input from AND and SKE in their respective areas of expertise. All authors critically reviewed and approved a final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.