Objective: NA.
Background: Over the past decade, Tenecteplase (TNK) has been proposed as an alternative thrombolytic agent to alteplase in adult acute ischemic stroke (AIS) patients. However, there is no data on TNK use in the pediatric population. The most updated pediatric stroke guidelines recommend tPA for children >2 yrs old with disabling neurological deficits within 4.5 hrs from symptom onset. TNK is more fibrin specific and has more resistance to plasminogen activator inhibitor, therefore may achieve better clot lysis compared to alteplase. TNK use in children is limited to few published cases for cardiac indications with good outcomes. Our case is the first reported pediatric patient to be treated with TNK for AIS.
Design/methods: NA.
Results: A 15-year-old male with a medical history of recent presumed bilateral tinea pedis currently on fluconazole presented to the emergency department (ED) with left-sided weakness and numbness which started 30 minutes before arrival at the ED. The initial blood pressure was 128/59 and blood glucose level was 119 mg/dL. The initial National Institute of Health Stroke Scale (NIHSS) was 7: 2 for left facial palsy, 3 for left arm weakness, and 2 for left leg weakness. Computerized tomography of the head demonstrated no acute abnormality. CT angiography (CTA) of the head and neck showed a nonocclusive thrombus in the M1 segment of the right middle cerebral artery (MCA). He received tenecteplase 0.25 mg/kg with improvement of his NIHSS score to 6. He subsequently underwent successful endovascular thrombectomy with complete recanalization, after which his symptoms resolved, and he returned to neurologic baseline with NIHSS 0.
Conclusions: TNK can be a safe and effective alternative to alteplase in the treatment of carefully selected children and adolescents with AIS. Further research in the pediatric population are needed to identify appropriate candidates, determine effective dosing, and delineate safety parameters. Dr. Elmashad has nothing to disclose. Dr. Fung has nothing to disclose. Akash Chakravartty has nothing to disclose. Dr. Mehta has nothing to disclose. Ryan Hebert has nothing to disclose. Dr. Beekman has nothing to disclose. Dr. Sunmonu has nothing to disclose.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1212/WNL.0000000000205076 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Recanalization for Symptomatic Non-acute Intracranial Large Vessel Occlusion: An Observational Study.
J Atheroscler Thromb
March 2025
Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital.
Aim: This study investigated the efficacy and safety of endovascular revascularization for symptomatic non-acute atherosclerotic intracranial LVO.
Methods: For non-acute atherosclerotic intracranial large vessel occlusion (LVO), despite aggressive medical treatment, recurrent ischemic stroke or transient ischemic attack related to the occluded artery still occurs repeatedly. This retrospective cohort study included stroke patients with intracranial LVO who received endovascular treatment (EVT), categorized by successful recanalization and the time interval from symptom onset to revascularization (＜30 days vs.
Assessment of the prognostic performance of TIMI, PAMI, CADILLAC and GRACE scores for short-term major adverse cardiovascular events in patients undergoing emergent percutaneous revascularisation: a prospective observational study.
BMJ Open
March 2025
National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Objectives: Accurately predicting short-term MACE (major adverse cardiac events) following primary percutaneous coronary intervention (PCI) remains a clinical challenge. This study aims to assess the effectiveness of four established risk scores in predicting short-term MACE after primary PCI.
Design: Prospective observational study.
Factors associated with prehospital and in-hospital delays in acute ischaemic stroke care in Indonesia: a systematic review.
BMJ Open
March 2025
Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Objectives: This systematic review examines prehospital and in-hospital delays in acute stroke care in Indonesia.
Design: Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Data Sources: We conducted a thorough search across 11 databases, ClinicalTrials.
p38γ modulates ferroptosis in brain injury caused by ethanol and cerebral ischemia/reperfusion by regulating the p53/SLC7A11 signaling pathway.
Cell Signal
March 2025
Department of Neurology, Northwest University School of Medicine, Xi'an 710068, China; Northwest University First Hospital, Xi'an 710043, China. Electronic address:
Ischemic stroke, a neurological condition with a complicated etiology that is accompanied by severe inflammation and oxidative stress, and ethanol (EtOH) may aggravate ischemia/reperfusion (I/R)-induced brain damage. However, the effect of prolonged alcohol intake on acute brain injury remains ambiguous. As part of the mitogen-activated protein kinase (MAPK) family, p38γ is involved in ferroptosis and inflammation in various diseases.
View Article and Find Full Text PDFShuxuetong Injection inhibits pyroptosis in acute ischemic stroke via CD44/NLRP3/GSDMD signal.
J Ethnopharmacol
March 2025
Beijing University of Chinese Medicine, Beijing, China 102488. Electronic address:
Ethnopharmacological Relevance: Acute ischemic stroke (AIS) is an important cause of death and disability in the world. Based on the blood stasis syndrome of stroke, Shuxuetong Injection (SXT) is a representative prescription for the treatment of AIS, which extracted by modern technology from Whitmania pigra Whitman (Shuizhi) and Pheretima aspergillum E.Perrier (Dilong).
View Article and Find Full Text PDFWant 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!