Stents for progressively symptomatic paediatric intracranial arterial dissection

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.