Stent placement for the treatment of a symptomatic intracranial arterial dissection in an adolescent

Abstract

Intracranial arterial dissection is an important cause of stroke in young patients. Treatment options include observation, antiplatelet or anticoagulation regimens, and endovascular stent placement. The authors describe the case of a 14-year-old boy who presented with a symptomatic, posttraumatic dissection extending from the intracranial internal carotid artery to the middle cerebral artery. Images obtained approximately 48 hours after this incident revealed a subacute right frontal lobe infarct, and a CT stroke study (CT angiography and CT perfusion) confirmed the vascular injury and associated decreased perfusion, prompting revascularization with a self-expanding stent. The patient did well clinically after stent placement and showed no evidence of restenosis on follow-up angiography 3 and 6 months later. This report is, to the authors' knowledge, the first description of the use of a stent for a symptomatic intracranial dissection in an adolescent.