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

• Published in: Journal of radiology case reports Vol. 18; no. 1; pp. 26 - 34
• Main Authors: Rezayev, Arthur, Coggins, William S, Amole, Adewumi, Kamran, Mudassar, Tanaka, Tomoko
• Format: Journal Article
• Language: English
• Published: United States EduRad 01-01-2024
• Subjects: Angiography, Digital Subtraction; Carotid Artery, Internal, Dissection - diagnostic imaging; Carotid Artery, Internal, Dissection - etiology; Carotid Artery, Internal, Dissection - therapy; Cerebral Infarction - diagnostic imaging; Cerebral Infarction - etiology; Child; Endovascular Procedures - methods; Female; Humans; Neuroimaging; Reperfusion; Stents; Ischemia; Perfusion; Dissection; Pediatric; Stent; Endovascular
• ISSN: 1943-0922; 1943-0922
• DOI: 10.3941/jrcr.v18i1.5217

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.
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.
A Neuroform Atlas stent was placed without complication. All dysarthria and weakness had resolved on follow-up 5 months post-stenting.
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.