Introduction: Posterior circulation stroke attributable to basilar artery thrombosis is a rare entity and is difficult to diagnose in young children. Given the high rate of disability and mortality associated with the condition, endovascular revascularization may be a potential treatment strategy.
Case: We describe a 3-year-old girl who presented with a decline in consciousness associated with tonic and clonic movements of her extremities thought to be secondary to a seizure. She was found to have a basilar artery occlusion 18 h from last known to be normal and was successfully treated with intra-arterial alteplase. At 6 month follow up the child has made substantial improvements and is in preschool with difficulties with ambulating longer distances.
Conclusion: We report the youngest patient in the literature to date who was treated with intra-arterial thrombolysis for an acute basilar artery occlusion.