Rare Emergency Neuro-Intervention in 2.5-Year-Old, Reversing Devastating Stroke Effects

National: What started as severe indigestion and mild fever in a two-and-a-half-year-old girl quickly escalated into repeated seizures, altered sensorium and sudden loss of movement.

At ApolloMedics Super Speciality Hospital, Lucknow, rapid diagnosis and a timely decision to escalate treatment enabled doctors to perform a rare, highly complex neuro-interventional procedure, intracranial catheter-directed thrombolysis, leading to significant neurological recovery.

The case, marked by rapid deterioration and a narrow window for intervention, will be presented at the Indian National Stroke Conference 2026 in Kochi, underlining both its clinical significance and the growing capabilities of advanced stroke care in India.

The child was diagnosed with deep Cerebral Venous Sinus Thrombosis (CVST) with multiple brain infarcts, a condition associated with high mortality risk and potentially devastating long-term neurological disability.

Recognising the urgency, the doctors took a critical, high-risk decision to escalate treatment without delay. A multidisciplinary team led by Dr. Dewansh Mishra, Interventional Neuro-Radiologist, along with Dr. Arpit Taunk and Dr. Amol Srivastava, performed the complex intracranial catheter-directed thrombolysis under general anaesthesia.

Through the femoral vein in the thigh, a microcatheter was carefully navigated into the intracranial venous system, and clot-dissolving medication was delivered directly at the site of thrombosis to restore venous drainage. This was successful in limiting further neurological damage.

Explaining the complexity and urgency of the case, Dr. Dewansh Mishra said, “Deep cerebral venous thrombosis in toddlers is exceptionally rare, and neurointervention in paediatric stroke is particularly challenging because of the small size of vessels and increased risk of bleeding.

Literature on catheter-directed thrombolysis in such young patients is limited. In this case, the child was deteriorating quickly, and timely escalation to precision neurointervention was crucial to prevent irreversible brain injury and give her the best possible chance of recovery.”

After nearly three weeks of intensive care and rehabilitation, the child was discharged with significant neurological recovery. She is now able to walk, speak, and perform activities that children of her age do. The successful outcome reflects timely escalation and coordinated critical care.

He further added that the child was diagnosed with Antiphospholipid Antibody (APLA) syndrome, a clotting disorder that increases the tendency of blood to clot excessively. Infection and dehydration further worsened the condition and accelerated stroke progression.

The paediatric critical care team, including Dr. Sciddhartha Kunwar, Dr. Nishant Gopal, Dr. Siddharth, and Dr. Anubhav Patel, played a pivotal role in stabilising and managing the child before and after the intervention, ensuring continuous monitoring through a highly vulnerable period.

Commenting on the broader significance of the case, Dr. Mayank Somani, MD and CEO, ApolloMedics Super Speciality Hospital, said, “This case is a reminder that stroke can occur even in very young children, and when it does, every minute matters.

Early recognition, urgent neuroimaging, and timely escalation to advanced intervention can be life-saving. The child’s recovery is deeply heartening and reflects what is possible when the right expertise and the right treatment come together at the right time.”