Traumatic Vertebral Artery Dissection and Basilar Artery Occlusion/Stroke in a 7-Year-Old Child: A Case Report

Abstract

Vertebral artery dissection (VAD) followed by basilar artery occlusion/stroke (BAO/BAS) is a rare but potentially life-threatening complication. We present a case report of a 7-year-old boy with VAD complicated by BAO/BAS 4 days after falling off a scooter. Symptoms included left-sided weakness and facial droop preceded by a 20-minute episode of altered sensorium. Magnetic resonance imaging showed ischemic changes in the left posterior inferior cerebellum and right pons. Computed tomography angiogram confirmed dissection of the left vertebral artery with occlusion/thrombosis of the basilar artery. Heparinization for 96 hours, followed by 6 months of low-molecular weight heparin injection, resulted in improvement of his neurological symptoms.

Basilar Artery Occlusion Caused by Extracranial Vertebral Artery Dissection on Its Entry into the Transverse Foramen of the C6 Vertebra: Case Report

“…By using the system of Catalyst 6 (Stryker, Kalamazoo, MI, USA)/Trevo Trak 21 (Stryker)/CHIKAI 0.014 (Asahi Intecc), MT was performed using a direct aspiration first-pass technique (ADAPT). 10) As a result, successful recanalization with thrombolysis in cerebral infarction score of 2b was achieved with 2 PASS (the times of MT procedure until recanalization); the time details were as follows: onset-to-recanalization time, 349 min; door-to-puncture time, 325 min; and puncture-to-recanalization time, 44 min ( Fig. 2B ).…”

“…By using the system of Catalyst 6 (Stryker, Kalamazoo, MI, USA)/Trevo Trak 21 (Stryker)/CHIKAI 0.014 (Asahi Intecc), MT was performed using a direct aspiration first-pass technique (ADAPT). 10) As a result, successful recanalization with thrombolysis in cerebral 2B). Additionally, the right VA flowed retrogradely via the union from the left VA (Fig.…”

“…1,[3][4][5][6][7][8][9] Additionally, BAO may sometimes occur in conjunction with artery-to-artery embolism secondary to vertebral artery dissection (VAD) and result in severe stroke in young patients. 1,2,6,10) VAD occurs spontaneously or secondary to external blunt force trauma. 8,[10][11][12][13] Regardless of whether it is spontaneous or secondary to trauma, it has been reported that VAD most commonly occurs at the V1−V2 junction at the level of the C6 vertebra (43%).…”

“…1,2,6,10) VAD occurs spontaneously or secondary to external blunt force trauma. 8,[10][11][12][13] Regardless of whether it is spontaneous or secondary to trauma, it has been reported that VAD most commonly occurs at the V1−V2 junction at the level of the C6 vertebra (43%). 14) On the other hand, some studies have shown that VAD tends to occur more frequently in the V2 (transverse foramen from C6 to C2) or V3 (from the transverse foramen of C2 to the entry into dura) segment (60%-77%) and less commonly at the V1 (from subclavian artery to entry into transverse foramen of C6 vertebra)-V2 junction (9%-22%).…”

Delayed Blunt Traumatic Carotid Artery Dissection After a Scooter Accident: A Case Report

“… 7 There is one case report of a seven-year-old male who sustained a traumatic vertebral artery dissection and basilar artery occlusion/stroke four days after falling off a scooter. 8 To our knowledge, there are no case reports of delayed ICAD from a scooter accident.…”