Pediatric Stroke: Large Vessel Occlusion in a 3-Year-Old Girl with Acute COVID-19, Treated with Mechanical Thrombectomy

With the coronavirus disease 2019 (COVID-19) surge in 2020, a link between the effects of the SARS-CoV-2 virus on vessel endothelial cells and the incidence of thrombotic disease and stroke quickly became suspected. Several case reports and series reporting stroke and stroke treatment in unusually young, previously healthy adults and children emerged. Current evidence suggests that young patients with acute SARS-CoV-2 infection in 2020–2022 had a higher risk of ischemic stroke than the comparable SARS-CoV-2-negative population. However, the role of the virus has not been fully elucidated. This chapter addresses the management of pediatric stroke, using the example of a 3-year-old girl who experienced an acute stroke associated with acute SARS-CoV-2 infection, and received a beneficial endovascular thrombectomy. This exemplary case illustrates the often complex treatment of pediatric stroke, which in this case was further complicated by COVID-19’s interference with thrombosis therapy and effects on thrombus development.