Childhood basilar artery occlusion: a report of 5 cases and review of the literature

J Child Neurol. 2014 May;29(5):633-45. doi: 10.1177/0883073813488826. Epub 2013 May 13.

Abstract

Basilar artery occlusion has poor outcome in adults; little is known regarding outcomes in children. Whether intra-arterial treatments improve adult outcomes is controversial. Safety and efficacy of intra-arterial treatments in children are unknown. We report 5 cases of basilar artery occlusion and review published cases. We estimated National Institute of Health Stroke Scale (NIHSS) and modified Rankin Score (mRS) of published cases, compared scores between non-intra-arterial treatments and intra-arterial treatments groups, and examined the correlation between NIHSS and mRS. Of our cases, 4 had good outcomes and 1 died. Of 63 published cases, 45 had no intra-arterial treatments and 18 had intra-arterial treatments. In the non-intra-arterial treatments group 24 had good outcomes. In the intra-arterial treatments group 13 had good outcomes. There was strong correlation between the NIHSS and the mRS. Children with basilar artery occlusion have better outcomes than adults. Certain children with basilar artery occlusion may be treated conservatively. A registry for childhood basilar artery occlusion is urgently needed.

Keywords: National Institute of Health Stroke Scale; basilar artery occlusion; intra-arterial treatment; modified Rankin Score; thrombolysis..

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Brain* / diagnostic imaging
  • Brain* / pathology
  • Child
  • Child, Preschool
  • Coronary Angiography
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Radionuclide Imaging
  • Tomography, X-Ray Computed
  • Vertebrobasilar Insufficiency* / diagnosis