Endovascular treatment of pediatric vertebral artery dissection: Case report and literature review

Introduction and importance

Vertebral artery dissection (VAD) is considered a rare disease in the pediatric population, with challenging to diagnose and treatment. The optimal management remains unclear. Outcome of endovascular treatment, is still rarely reported. Along with a literature review, we aimed to provide information of clinical manifestation, treatment and prognosis in endovascular treatment of pediatric VAD.

Presentation of case

Two endovascular treated cases of spontaneous pediatric VAD were retrospectively reviewed. Clinical symptoms were only headache. Diagnosis was confirmed by DSA. Endovascular coils occlusions of parental vertebral artery were performed in two cases. Both individuals experienced a full recovery, and there were no further occurrences of symptoms or new infarction.

Clinical discussion

VAD is a rare but significant cause of stroke in children. Its incidence in the pediatric population is low, with males being more frequently affected than females. Treatment options for pediatric VAD include conservative medical management, surgical intervention, and endovascular therapy. Endovascular treatment, though less commonly reported, has shown promise in achieving good clinical outcomes with minimal complications. We report two pediatric cases of VAD treated with endovascular therapy. Both patients presented with headache as the primary symptom and achieved full recovery without neurological deficits. Endovascular treatment appears to be a safe and effective option for pediatric VAD, especially in cases where conservative management is insufficient or surgical intervention is not feasible.

Conclusions

Pediatric VAD is rare and endovascular treatment is feasible for the treatment. More research will still be needed to demonstrate the superiority in clinical outcomes with endovascular therapy.