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Complete functional recovery in a child after endovascular treatment of basilar artery occlusion caused by spontaneous dissection: a case report
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.ORCID iD: 0000-0001-8190-4252
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Neurooncology and neurodegeneration.ORCID iD: 0000-0003-1043-5385
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.ORCID iD: 0000-0002-2502-6026
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Enblad: Neurosurgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurosurgery.ORCID iD: 0000-0002-4702-526X
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2022 (English)In: Child's Nervous System, ISSN 0256-7040, E-ISSN 1433-0350, Vol. 38, no 8, p. 1605-1612Article in journal (Refereed) Published
Abstract [en]

Stroke caused by dissection of arteries of the vertebrobasilar system in children is still poorly investigated in terms of etiology, means of treatment, course of disease, and prognosis. The aim of this report was to describe the unusual course of a spontaneous dissection of the basilar artery (BA) in a child treated with endovascular techniques and to point out that the plasticity of the brain stem can fully compensate for structural damage caused by stroke. We report the case of a 15-year-old boy who suffered a wake-up stroke with BA occlusion caused by spontaneous dissection. A blood clot was aspirated from the false lumen and the true lumen re-opened, but the patient deteriorated a few hours later, and repeated angiography revealed that the intimal flap was detached, occluding the BA again. The lumen of BA was then reconstructed by a stent. Despite a large pons infarction, the patient was completely recovered 11 months after the onset. The case was analyzed with angiograms and magnetic resonance imaging, macroscopic and microscopic pathological analysis, computed tomographic angiography, magnetic resonance-based angiography, and diffusion tensor imaging. This case illustrates that applied endovascular techniques and intensive care measures can alter the course of potentially fatal brain stem infarction. Our multimodal analysis gives new insight into the anatomical basis for the plasticity mechanism of the brain stem.

Place, publisher, year, edition, pages
Springer Nature, 2022. Vol. 38, no 8, p. 1605-1612
Keywords [en]
Pons, Infarction, Diffusion tensor imaging
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-464332DOI: 10.1007/s00381-021-05428-wISI: 000729010300001OAI: oai:DiVA.org:uu-464332DiVA, id: diva2:1627621
Note

A Correction to this article was published on 11 January 2022. In this article the author name “Sylwia Libard” was incorrectly written as “Sylvia Libard”.The original article has been corrected.

Available from: 2022-01-13 Created: 2022-01-13 Last updated: 2023-07-04Bibliographically approved

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Borota, LjubisaLibard, SylwiaFahlström, MarkusLatini, FrancescoLundström, Erik

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