Background And Purpose: No controlled, randomized trial has investigated whether intravenous, intra-arterial (IAT), or mechanical thrombolysis is beneficial in children with ischemic stroke. We report 2 children who underwent IAT for acute ischemic stroke and include them in a review about intravenous thrombolysis, IAT, and mechanical thrombolysis for childhood stroke.
Methods: We searched in MEDLINE and EMBASE for studies that reported on treatment of childhood stroke with intravenous thrombolysis, IAT, or mechanical thrombolysis in the presence of occlusion of the basilar artery, sphenoidal, or insular middle cerebral artery. To be included in this review, the following findings had to be reported: (1) stroke severity at presentation; (2) cerebral imaging findings before thrombolysis; (3) time to treatment; (4) dose of the thrombolytic agent; (5) pre- and postinterventional angiographic findings in IAT; and (6) outcome assessed at hospital discharge or within 12 months after thrombolysis.
Results: Adequate data were available in 17 children (including our 2 own cases) who underwent intravenous thrombolysis (n=6), IAT (n=10), or mechanical thrombolysis (n=1). No symptomatic intracranial hemorrhage occurred, but 2 asymptomatic intracranial hemorrhages were present. Sixteen children (94%) survived, and 12 (71%) had a good outcome (modified Rankin Scale score 0 or 1).
Conclusions: The available data about thrombolysis in pediatric stroke are limited. They suggest that this treatment may be beneficial in children with ischemic stroke. Controlled, randomized trials are needed to determine whether thrombolysis is useful in childhood stroke.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/STROKEAHA.108.529560 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pretreatment Cranial Computed Tomography Perfusion Predicts Dynamic Cerebral Autoregulation Changes in Acute Hemispheric Stroke Patients Having Undergone Recanalizing Therapy: A Retrospective Study.
Neurol Int
November 2024
Department of Radiology, Section Neuroradiology, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland.
Objectives: Blood pressure (BP) management is challenging in patients with acute ischemic supratentorial stroke undergoing recanalization therapy due to the lack of established guidelines. Assessing dynamic cerebral autoregulation (dCA) may address this need, as it is a bedside technique that evaluates the transfer function phase in the very low-frequency (VLF) range (0.02-0.
View Article and Find Full Text PDFOutcomes and Complications Associated with Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke.
Cardiol Cardiovasc Med
December 2024
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA.
Universally, stroke presents as neurological deficits due to the obstruction of blood supply to specific regions of the brain. Among the three main categories of stroke, acute ischemic stroke is the leading cause of death and disability worldwide. As of today, there are two effective treatment methods: thrombolysis and endovascular therapy.
View Article and Find Full Text PDFClearing Disseminated Venous Thromboembolism in a Single Procedure Using Thrombolytic-Free Large Bore Suction Thrombectomy: A Versatile Toolbox to Unclog the Venous Circulation.
Ann Vasc Dis
December 2024
Digestive & Liver Surgery, Singapore.
Disseminated venous thromboembolism (VTE) occurs commonly in cancer patients, who tend to have contraindications to systemic thrombolysis and require cancer surgery. Such clinical scenarios are often challenging to manage. In this case report, we illustrate an innovative, single procedural approach in such a patient to remove extensive VTE, improve symptoms, prevent hemodynamic decompensation, and allow for a minimal level of anticoagulation such that necessary cancer surgery can proceed safely.
View Article and Find Full Text PDFConcurrent acute myocardial infarction and acute ischemic stroke in a diabetic patient undergoing chemotherapy for non-Hodgkin lymphoma: Should I administer thrombolytic therapy? A case report.
Egypt Heart J
December 2024
Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania.
Background: Concurrent ST-elevation myocardial infarction (STEMI) and acute ischemic stroke (AIS) are extremely rare, and their management remains perplexing due to the absence of high-quality evidence and limited resources. For the first time, we report a rare, preventable, and suboptimally managed case of concurrent AIS and STEMI in a patient with non-Hodgkin lymphoma (NHL) who received cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy.
Case Presentation: A 59-year-old postmenopausal woman of African origin with a background history of type 2 diabetes mellitus presented to the Jakaya Kikwete Cardiac Institute with sudden onset of left-sided weakness and typical ischemic chest pain for 3 days.
Influence of vascular embolism level and drug injection rate on thrombolytic therapy of bifurcated femoral vein: Numerical simulation and validation study.
Comput Methods Programs Biomed
December 2024
College of Mechanical and Electrical Engineering, Wenzhou University, Wenzhou, 325035, China.
Background And Objective: Deep vein thrombosis (DVT) of the lower limbs is a critical global vascular disease. Accurately assessing and predicting the efficacy of DVT treatment remains a significant challenge due to a lack of understanding of the mechanisms by which the level of patient-specific embolization and the rate of drug injection affect thrombolytic therapy.
Methods: In this study, we used the computed tomographic venography (CTV) clinical method to obtain patient-specific parameters, and the flow-solid interaction (FSI) method combined with biochemical response modeling of thrombolysis to analyze patient-specific hemodynamic and biomechanical characteristics and to quantitatively assess the effects of three vessel embolism levels (VEL) versus two drug injection rates (DIR) on bifurcated femoral venous thrombolytic therapy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!