Clinically successful late recanalization of basilar artery occlusion in childhood: what are the odds? Case report and review of the literature

J Neurol Sci. 2007 Sep 15;260(1-2):256-60. doi: 10.1016/j.jns.2007.03.028. Epub 2007 May 4.


Background and purpose: Acute basilar artery occlusion is an infrequent but potentially fatal cause of stroke, both in adults and children. We present our experience with a 6-year-old child and we investigate the rationality for late treatment of acute basilar occlusion in children.

Methods: We report the case of a 6-year-old boy with acute basilar artery occlusion presented with a full blown locked-in syndrome, admitted to the endovascular suite 44 h after the stroke onset, and we review all the reported cases of basilar artery occlusions presented with locked-in syndrome in children.

Results: Six hours following admission the basilar artery was partially recanalized by intra-arterial thrombolysis combined with mechanical clot angioplasty. After 12 h, the patient was awake, oriented, his speech function was fully restored and he had only a mild right hemiparesis that recovered completely after a month.

Conclusions: To our knowledge, this is the first report of complete clinical recovery after delayed (50 h) endovascular recanalization of basilar artery in a child. Intra-arterial thrombolysis combined with cerebral angioplasty, can successfully restore the patency of the basilar artery and the neurologic deficit of children with acute basilar artery occlusion, even after a considerable delay.

Publication types

  • Case Reports

MeSH terms

  • Age Factors
  • Angioplasty, Balloon / methods*
  • Angioplasty, Balloon / trends
  • Anticoagulants / administration & dosage
  • Basilar Artery / diagnostic imaging
  • Basilar Artery / pathology
  • Basilar Artery / surgery*
  • Brain Stem Infarctions / etiology
  • Brain Stem Infarctions / pathology
  • Brain Stem Infarctions / therapy*
  • Child
  • Heparin / administration & dosage
  • Humans
  • Male
  • Pons / blood supply
  • Pons / pathology
  • Pons / physiopathology
  • Quadriplegia / etiology
  • Quadriplegia / pathology
  • Quadriplegia / therapy
  • Radiography
  • Thrombolytic Therapy / methods*
  • Thrombolytic Therapy / trends
  • Time Factors
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / administration & dosage
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / pathology
  • Vertebrobasilar Insufficiency / therapy*


  • Anticoagulants
  • Heparin
  • Urokinase-Type Plasminogen Activator