Pediatric Middle Cerebral Artery Occlusion with Dissection Following a Trampoline Trauma

Adeeb, Nimer; Storey, Christopher; Vega, Alexis J.; Aslan, Asala; Guthikonda, Bharat; Cuellar‐Saenz, Hugo

doi:10.1016/j.wneu.2020.07.175

Cited by 5 publications

(9 citation statements)

References 21 publications

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“…The patient and intervention characteristics are summarized in Table 1 . A total of 14 case reports with 21 cases (including the current report) were included in the review [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] .…”

Section: Discussionmentioning

confidence: 99%

Primary mechanical thrombectomy for anterior circulation stroke in children: Report of two cases and literature review

Christi

Suroto

Bajamal³

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Pediatric acute ischemic stroke is a rare but devastating condition with substantial rates of morbidity and mortality. Endovascular treatment is standard acute revascularization therapy for stroke in adults, but it is not well-studied in pediatrics. We report the successful treatment of two pediatric cases of anterior circulation stroke with primary mechanical thrombectomy. Case presentation Two Asian children, aged 13 and 8 years, presented to Dr. Soetomo General Academic Hospital in September 2020 and April 2021, respectively, with hemiplegia and significant Pediatric National Institutes of Health Stroke Scale (Ped NIHSS) scores. Head CT scans demonstrated hyperdense middle cerebral artery signs, suggesting large-vessel occlusion stroke. Both patients underwent emergent thrombectomy within 5 and 10 h after initial onset, and successful recanalization was achieved within an hour. Both demonstrated good neurological recovery and there was no recurrent stroke during follow-up. Clinical discussion Thrombectomy has appeal for childhood acute ischemic stroke (AIS) due to a longer post-stroke time window for intervention. As the short-term outcome, a significantly reduced Ped NIHSS score is achieved. Long-term outcomes are measured by modified Rankin Scale (mRS) scores. A literature review from 2016 to 2021 yielded 21 pediatric case reports of primary mechanical thrombectomy for anterior circulation stroke (including the present cases). We compare our cases with the published literature to discuss the short-term and long-term outcomes. Conclusion Mechanical thrombectomy holds promise as a treatment modality in pediatric AIS. These case reports described successful primary mechanical thrombectomy for AIS treatment in children.

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Section: Discussionmentioning

confidence: 99%

Primary mechanical thrombectomy for anterior circulation stroke in children: Report of two cases and literature review

Christi

Suroto

Bajamal³

et al. 2021

International Journal of Surgery Case Reports

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“…9 A separate recent case report described an 11-year-old female who suffered MCA dissection with large vessel occlusion after a fall on a trampoline. 10 Following clot removal, the treatment team attained a TICI 2b 8.5 hours following symptom onset. 10 On literature review, the researchers found only 20 pediatric patients with anterior AIS treated via thrombectomy with stent retrievers, with mean age of 10.6 years.…”

Section: Discussionmentioning

confidence: 99%

“…10 Following clot removal, the treatment team attained a TICI 2b 8.5 hours following symptom onset. 10 On literature review, the researchers found only 20 pediatric patients with anterior AIS treated via thrombectomy with stent retrievers, with mean age of 10.6 years. 10 Of these patients, 14 achieved a TICI of 2b or better, with dramatic improvements presumably owing to superior collateral circulation and neuroplasticity of the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…10 On literature review, the researchers found only 20 pediatric patients with anterior AIS treated via thrombectomy with stent retrievers, with mean age of 10.6 years. 10 Of these patients, 14 achieved a TICI of 2b or better, with dramatic improvements presumably owing to superior collateral circulation and neuroplasticity of the pediatric population. 10 A recent retrospective analysis demonstrated improved angiographic outcomes following thrombectomy in 12 children with large-vessel occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…10 Of these patients, 14 achieved a TICI of 2b or better, with dramatic improvements presumably owing to superior collateral circulation and neuroplasticity of the pediatric population. 10 A recent retrospective analysis demonstrated improved angiographic outcomes following thrombectomy in 12 children with large-vessel occlusion. 3 Most patients demonstrated improved neurologic function, with mean NIHSS score of 12.5 on admission and 3.5 on day 7 post-thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric internal carotid artery dissection and stroke after minor head injury

et al. 2021

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Severe and traumatic injuries associated with home trampoline use in children and adolescents: A systematic review

Eslick

Nuñez

Elliott

2022

Academic Emergency Medicine

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Trampolining is a popular form of recreation and trampolines are among the most common gifts to school age children and preadolescents. 1 However, trampolining poses a significant risk of injury, which accounts annually for nearly 100,000 pediatric emergency visits in the United States. 2 A recent meta-analysis of 11 studies with 1,386,843 trampoline injuries compared the type and site of injury sustained at trampoline centers and on home trampolines. 3 The study identified that musculoskeletal and/or orthopedic injuries, lower-extremity injury, sprains, or a need for surgery were more likely to result from injuries sustained at trampoline centers rather than on home trampolines. 3 Conversely, upper-extremity injury (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.05-4.00), concussion (OR 2.08, 95% CI 1.54-2.86), and lacerations (OR 2.17, 95% CI 1.69-2.86) were more likely to occur in the home compared to trampoline centers. 3 Previous studies have suggested that serious injuries are more likely to occur at trampoline centers than on home trampolines. [2][3][4][5] More than a decade ago, the American Academy of Pediatrics (AAP) and the Canadian Pediatric Society (CPS) issued policy statements advising against the recreational use of home trampolines because of the unacceptable risks. 6,7 Since then, trampoline injuries have not decreased, but have almost doubled in the United States. 2 Recent data suggest that most trampoline injuries that occur within the home environment result from improper landing onto or falling off the trampoline. 8 We conducted a systematic literature review to identify existing evidence on severe and traumatic trampoline injuries that occurred in the home environment, by type and site of injury, and treatment outcomes in children and adolescents aged ≤ 18 years. We followed the PRISMA guidelines. 9 A systematic search of the databases MEDLINE, Scopus, Google Scholar, and EMBASE was performed up to August 29, 2022, to identify relevant articles. Our search terms included ((trampoline) AND ((wound and injuries) OR (trauma)) OR (accident) OR (injury)). The reference lists of relevant articles were also searched for appropriate studies. No language or time limits were used in either the search or the study selection. No search for unpublished literature was performed. We included studies that reported severe or traumatic injury associated with trampoline use among children or adolescents. A severe injury was defined as a physical injury that results a significant injury that includes dismemberment, organ damage, physical disfigurement, fractured bones, permanent disabilities, and a limited ability to perform daily activities. Traumatic injury was defined as a physical injury of sudden onset and severity that requires immediate medical attention. Data extraction was performed using a standardized form and included information on the publication year, participant age and gender, study design, country, trampoline activity, symptoms and signs, type and place of injury, and outcome.

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Pediatric Middle Cerebral Artery Occlusion with Dissection Following a Trampoline Trauma

Cited by 5 publications

References 21 publications

Primary mechanical thrombectomy for anterior circulation stroke in children: Report of two cases and literature review

Primary mechanical thrombectomy for anterior circulation stroke in children: Report of two cases and literature review

Pediatric internal carotid artery dissection and stroke after minor head injury

Severe and traumatic injuries associated with home trampoline use in children and adolescents: A systematic review

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