Back to Search Start Over

Pediatric Stroke due to Thoracic Outlet Syndrome Treated with Thrombolysis and Thrombectomy: A Case Report

Authors :
Dhanalakshmi Angappan
McKinnon Garrett
Candice Henry
Art Riddle
Jenny L. Wilson
Source :
Children, Vol 9, Iss 6, p 875 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Thoracic outlet syndrome (TOS) is a condition that results from the compression of neurovascular structures as they exit the thorax. Arterial ischemic stroke can occur in TOS due to retrograde embolism from the subclavian artery. We describe a 15-year-old girl who presented with left hemiplegia after 2 weeks of right arm numbness and tingling. Imaging showed an acute ischemic stroke due to a right middle cerebral artery occlusion. She was treated with intravenous tissue plasminogen activator at 1.3 h and mechanical thrombectomy at 2.4 h with successful recanalization. Review of her neck computed tomography angiogram suggested a right subclavian artery aneurysm, and upper-extremity imaging also demonstrated distal thrombosis and fusion of right first and second ribs, which was consistent with thoracic outlet syndrome. Three days later, she underwent a right subclavian artery aneurysm repair, right brachial and ulnar artery thrombectomy, and first rib resection. Three months later, she demonstrated good neurologic recovery. TOS is an uncommon cause of stroke in children, which may be heralded by upper-extremity symptoms. Interventionalists should be aware of the possibility of vascular anomalies in children; however, this finding does not exclude the possibility of acute stroke intervention.

Details

Language :
English
ISSN :
22279067
Volume :
9
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Children
Publication Type :
Academic Journal
Accession number :
edsdoj.2e551bd488c542f3a492f9304dfffd11
Document Type :
article
Full Text :
https://doi.org/10.3390/children9060875