Treatment of a basilar artery occlusion with intra-arterial thrombolysis in a 3-year-old girl.

INTRODUCTION

Posterior circulation stroke attributable to basilar artery thrombosis is a rare entity and is difficult to diagnose in young children. Given the high rate of disability and mortality associated with the condition, endovascular revascularization may be a potential treatment strategy.

CASE: We describe a 3-year-old girl who presented with a decline in consciousness associated with tonic and clonic movements of her extremities thought to be secondary to a seizure. She was found to have a basilar artery occlusion 18 h from last known to be normal and was successfully treated with intra-arterial alteplase. At 6 month follow up the child has made substantial improvements and is in preschool with difficulties with ambulating longer distances.

CONCLUSION

We report the youngest patient in the literature to date who was treated with intra-arterial thrombolysis for an acute basilar artery occlusion.