ABSTRACT
Stroke in children is a rare but devastating disease. Although endovascular treatment has been reported to be safe and effective in the treatment of stroke with large vessel occlusion in this population, there are still limitations and controversies. In this case report, we describe a 12-month-old girl who was admitted to the hospital with acute onset of left-sided hemiplegia and confusion, which turned out to be due to a large infarct in the right middle cerebral artery territory, possibly caused by dissection of the right cervical internal carotid artery. Aspiration thrombectomy was successfully performed, and the patient was able to walk a few steps and raise her left upper extremity at the 12-month follow-up. The aspiration-only technique in thrombectomy may be safe and technically feasible to treat acute ischemic stroke with large vessel occlusion in children as young as 12 months, although large-volume prospective studies are needed.
ABSTRACT
Carotid stenosis is seen in about 10% of patients with ischemic stroke. Many studies have been performed that provide insight into the natural history, diagnosis, and optimal management of carotid disease. Both medical management and surgery have advanced to the point that patients and their providers have many options when considering treatment. Over the last several years, carotid artery stenting has been shown to be a viable treatment choice in selected patients. Both stenting and endarterectomy are superior to medical management alone in stroke prevention when patients are properly selected. In this article we try to review the most recent data regarding the two procedures in the treatment of carotid stenosis and also discuss the controversies in carotid artery revascularization
ABSTRACT
Previous reports have suggested that 6% to 39% of ischemic strokes are caused by cardiogenic emboli [1] Thrombus formation associated with atrial fibrillation has been reported as one of the most important cardiac sources of embolism[2] Using transesophageal echocardiography [TEE], other possible sources of embolism, including atrial septal aneurysm,[3] patent foramen ovale [PFO],[4] aortic atherosclerotic plaque,[5] annular calcification of the mitral valve,[6] mitral valve prolapse [MVP],[7] prosthetic cardiac valves and endocarditis,[8] mural thrombi,[9] cardiac tumors[10], and cardiac transplants[11] have been reported as risk factors for ischemic stroke. TEE is considered more sensitive than transthoracic echocardiography [TTE] in detecting cardiac abnormalities in patients with stroke and transient ischemic attacks [12] As there is no data available in Iran regarding TEE findings after embolic cerebrovascular accident [CVA], this study was undertaken to assess the prevalence of cardiac abnormalities by the TEE technique in patients with stroke