{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:54:33Z","timestamp":1772240073272,"version":"3.50.1"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"20","license":[{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Mechanical thrombectomy (MT) has been proved to be a highly effective therapy to treat acute ischemic stroke due to large vessel occlusion. Often, the ischemic core extent on baseline imaging is an important determinant for endovascular treatment eligibility. However, computed tomography (CT) perfusion (CTP) or diffusion-weighted imaging may overestimate the infarct core on admission and, consequently, smaller infarct lesions called \u201cghost infarct cores.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 4-year-old, previously healthy boy presented with acute-onset, right-sided weakness and aphasia. Fourteen hours after the onset of symptoms, the patient presented with a National Institutes of Health Stroke Scale (NIHSS) score of 22, and magnetic resonance angiography demonstrated a left middle cerebral artery occlusion. MT was not considered because of a large infarct core (infarct core volume: 52 mL; mismatch ratio 1.6 on CTP). However, multiphase CT angiography indicated good collateral circulation, which encouraged MT. Complete recanalization was achieved via MT at 16 hours after the onset of symptoms. The child\u2019s hemiparesis improved. Follow-up magnetic resonance imaging was nearly normal and showed that the baseline infarct lesion was reversible, in agreement with neurological improvement (NIHSS score 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The selection of pediatric stroke with a delayed time window guided by good collateral circulation at baseline seems safe and efficacious, which suggests a promising value of vascular window.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case22404","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T09:30:41Z","timestamp":1684834241000},"source":"Crossref","is-referenced-by-count":1,"title":["Collateral circulation status\u2013guided mechanical thrombectomy in pediatric stroke with an extended ghost infarct core: illustrative case"],"prefix":"10.3171","volume":"5","author":[{"given":"Tian-Min","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Neurology, Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun-Xin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Long","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"J Neurointerv Surg","first-page":"729","article-title":"Endovascular thrombectomy in pediatric patients with large vessel occlusion","volume":"11","author":"Shoirah H","year":"2019","unstructured":"Shoirah H, Shallwani H, Siddiqui AH,  Endovascular thrombectomy in pediatric patients with large vessel occlusion. J Neurointerv Surg. 2019;11(7):729\u2013732.30842301"},{"issue":"1","key":"b2","series-title":"J Neurointerv Surg","first-page":"66","article-title":"Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept","volume":"9","author":"Boned S","year":"2017","unstructured":"Boned S, Padroni M, Rubiera M,  Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept. J Neurointerv Surg. 2017;9(1):66\u201369.27566491"},{"issue":"2","key":"b3","series-title":"Radiology","first-page":"510","article-title":"Multiphase ct angiography: a new tool for the imaging triage of patients with acute ischemic stroke","volume":"275","author":"Menon BK","year":"2015","unstructured":"Menon BK, d\u2019Esterre CD, Qazi EM,  Multiphase ct angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology. 2015;275(2):510\u2013520.25633505"},{"issue":"11","key":"b4","series-title":"JAMA Neurol","first-page":"1361","article-title":"Clinical imaging factors associated with infarct progression in patients with ischemic stroke during transfer for mechanical thrombectomy","volume":"74","author":"Boulouis G","year":"2017","unstructured":"Boulouis G, Lauer A, Siddiqui AK,  Clinical imaging factors associated with infarct progression in patients with ischemic stroke during transfer for mechanical thrombectomy. JAMA Neurol. 2017; 74(11):1361\u20131367.28973081"},{"issue":"9","key":"b5","series-title":"Stroke","first-page":"2604","article-title":"Early collateral recruitment after stroke in infants and adults","volume":"50","author":"Bonnin P","year":"2019","unstructured":"Bonnin P, Mazighi M, Charriaut-Marlangue C, Kubis N. Early collateral recruitment after stroke in infants and adults. Stroke. 2019; 50(9):2604\u20132611.31337296"},{"issue":"7","key":"b1","series-title":"J Neurointerv Surg","first-page":"729","article-title":"Endovascular thrombectomy in pediatric patients with large vessel occlusion","volume":"11","author":"Shoirah H","year":"2019","unstructured":"Shoirah H, Shallwani H, Siddiqui AH,  Endovascular thrombectomy in pediatric patients with large vessel occlusion. J Neurointerv Surg. 2019;11(7):729\u2013732.30842301"},{"issue":"1","key":"b2","series-title":"J Neurointerv Surg","first-page":"66","article-title":"Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept","volume":"9","author":"Boned S","year":"2017","unstructured":"Boned S, Padroni M, Rubiera M,  Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept. J Neurointerv Surg. 2017;9(1):66\u201369.27566491"},{"issue":"2","key":"b3","series-title":"Radiology","first-page":"510","article-title":"Multiphase ct angiography: a new tool for the imaging triage of patients with acute ischemic stroke","volume":"275","author":"Menon BK","year":"2015","unstructured":"Menon BK, d\u2019Esterre CD, Qazi EM,  Multiphase ct angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology. 2015;275(2):510\u2013520.25633505"},{"issue":"11","key":"b4","series-title":"JAMA Neurol","first-page":"1361","article-title":"Clinical imaging factors associated with infarct progression in patients with ischemic stroke during transfer for mechanical thrombectomy","volume":"74","author":"Boulouis G","year":"2017","unstructured":"Boulouis G, Lauer A, Siddiqui AK,  Clinical imaging factors associated with infarct progression in patients with ischemic stroke during transfer for mechanical thrombectomy. JAMA Neurol. 2017; 74(11):1361\u20131367.28973081"},{"issue":"9","key":"b5","series-title":"Stroke","first-page":"2604","article-title":"Early collateral recruitment after stroke in infants and adults","volume":"50","author":"Bonnin P","year":"2019","unstructured":"Bonnin P, Mazighi M, Charriaut-Marlangue C, Kubis N. Early collateral recruitment after stroke in infants and adults. 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