Document Detail

Basilar artery occlusion in a child: "clot angioplasty" followed by thrombolysis.
MedLine Citation:
PMID:  11007500     Owner:  NLM     Status:  MEDLINE    
Basilar artery occlusions are rare but have a very poor prognosis. Intra-arterial thrombolysis may produce recanalization and better clinical outcome. A short delay between the onset of symptoms and thrombolysis is considered essential for successful recanalization and for the smallest possible risk of haemorrhagic complications. We present a case of basilar artery occlusion in an 8-year-old child, which was treated by "clot angioplasty" followed by intra-arterial thrombolysis. Thirty hours after progressive alteration of consciousness, speech disturbances and left arm paresis, the child became comatose with decerebrate rigidity. A CT scan showed parenchymal ischaemic lesions. Angiography (performed 36 h after the onset of symptoms) showed a total occlusion of the basilar artery. A clot angioplasty was performed by placing a balloon catheter within the thrombus and inflating it several times in the occluded segment of the basilar artery. Thrombolysis was then performed through the balloon catheter. The basilar artery was only partially recanalized at the end of the procedure, but the perforating arteries of the brain stem had reappeared on angiography. Three months later the child had completely recovered to a normal clinical status. In conclusion, the very poor natural prognosis of basilar artery occlusion requires aggressive management. Recanalization of the basilar artery may be performed even late after the onset of symptoms. Clot angioplasty allows partial recanalization, which may increase the efficiency of thrombolysis.
C Cognard; A Weill; S Lindgren; M Piotin; L Castaings; J Moret
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  16     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2001-02-02     Completed Date:  2001-02-02     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  496-500     Citation Subset:  IM    
Service de Neuroradiologie, Hôpital Purpan, Toulouse, France.
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MeSH Terms
Acute Disease
Angioplasty, Balloon / methods*
Arterial Occlusive Diseases / diagnosis*,  drug therapy*
Basilar Artery* / pathology,  radiography
Cerebral Angiography
Magnetic Resonance Imaging
Plasminogen Activators / therapeutic use*
Thrombolytic Therapy / methods*
Tomography, X-Ray Computed
Urokinase-Type Plasminogen Activator / therapeutic use*
Reg. No./Substance:
EC 3.4.21.-/Plasminogen Activators; EC Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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