TICI 3 Revascularization after Atypical Presentation of Basilar Occlusion in the Setting of a Pediatric Patient

Stroke at a young age is a rarely reported entity whether it is uncommon or overlooked. When it occurs, it can result in lifetime neurological deficits and disabilities for the child and an overwhelming emotional and mental challenge to caregivers. One of the reasons that can lead childhood stroke to be overlooked is an atypical presentation onset with a headache or acute symptomatic seizure. As time is brain, these differences in childhood stroke can lead to a delay in diagnosis and symptoms considered as a stroke mimic. Furthermore, posterior circulation stroke can present nonspecific symptoms that can challenge the early diagnosis, leading to delay in treatment and missing the window of safety. Although guidelines recommend considering IV thrombolytic (last known well within 4.5 hours) or endovascular thrombectomy (EVT) (last known well within 6 hours) for children who may benefit from as long as images are confirming, there is still minimal data on childhood ischemic stroke. Here we report a case of a pediatric patient with basilar artery occlusion who presented with an uncommon presentation of thunderclap headache and received successful therapy with mechanical thrombectomy.