Decompressive hemicraniectomy in a 5 year old patient with middle cerebral artery ischemic stroke: case report

Abstract

Ischemic stroke (CVA) in childhood is a rare entity that has been increasing in frequency and pathology represents a high risk of adverse events in children, additionally it is a pathology difficult to handle and with multiple recurrences. Pediatric patients with this kind of pathology and reaching the pediatric emergency department are difficult to establish a diagnosis and a fast management, since this entity has multiple differential diagnoses and their low incidence does not have clear algorithms and therapies fast and safe to counteract the severe neurological compromise patient. Because there are few studies in pediatric stroke describing the appropriate medical management or interventions for this disease, for which there are no clear guidelines to counteract the acute event. Therefore, there are interventions such as thrombectomy and decompressive craniectomy, leading to pediatric patients at a higher risk, but they have a favorable response in mortality, with a favorable recovery. We report a case of a pediatric patient with stroke in the territory of the right middle cerebral artery, diagnosis and definitive treatment, with review of the literature.