Background/aims: Arterial ischemic stroke (AIS) is rare in children compared to adults, however, may cause long-term morbidity and mortality. Thrombo-embolectomy is a standard treatment choice in selected adult patients, yet a small number of cases have been reported in children.

Methods:

Case 1: A 16-year-old girl was admitted 1 hour after onset of numbness and weakness on the left side of her body. Neurological examination revealed left hemiparesis. Her past medical history was remarkable for diagnosis of hypertrophic cardiomyopathy. MRI showed acute ischemic areas in the right basal ganglia level, the absence of flow in the right ICA, susceptibility artifact in the right MCA M1 segment suggesting the presence of thrombus.

Case 2: A 17-year-boy was admitted 1 hour after onset of speech impairment, weakness on the right side. Past medical history revealed aortic valve replacement at 15 years of age. However, he has discontinued anticoagulant treatment for the last 3 months. CT angiography showed acute occlusion affecting the left MCA M1 distal and bifurcation loops, and the distal branches showed filling with collaterals.

Intraarterial thrombectomy was performed in both patients within the critical first 4 hours. Both patients were monitored with anticoagulation therapy in the intensive care unit and were discharged without any neurological deficit.

Conclusion: Clinical trials demonstrate the effectiveness of endovascular techniques in adults with AIS, however sufficient data are not available for children. Thrombo-embolectomy with endovascular techniques, especially in the adolescent age group, provides satisfactory results in carefully selected patients at experienced centers.