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Pediatric Emergency Care:
doi: 10.1097/PEC.0b013e31821dc6e8
Illustrative Cases

Successful Intravenous Thrombolysis in a 14-Year-Old Boy With Ischemic Stroke

Sampaio, Isabel MD*; Abecasis, Francisco MD†; Quintas, Sofia MD‡; Moreno, Teresa MD‡; Camilo, Cristina MD†; Vieira, Marisa MD†; Pinho e Melo, Teresa MD§; Correia, Manuela MD†

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Abstract

Abstract: We report a healthy 14-year-old boy with an acute left middle cerebral artery stroke, treated 2 hours after the onset of symptoms with intravenous recombinant tissue plasminogen activator (r-TPA). Recanalization of the middle cerebral artery was documented with transcranial Doppler during the first 5 minutes of intravenous r-TPA perfusion, and progressive recovery of the neurological deficits occurred. Although lack of evidence regarding safety and efficacy in children precludes the recommendation of systematic use of r-TPA in pediatric stroke, we propose that this option should be considered and discussed with the parents, especially in older children presenting within 3 hours in centers with experience in adult thrombolysis.

© 2011 Lippincott Williams & Wilkins, Inc.

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