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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

doi: 10.1097/PEC.0b013e31821dc6e8
Illustrative Cases

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.

From the *Pediatrics Department; †Pediatric Intensive Care Unit and ‡Pediatric Neurology Division, Pediatrics Department; and §Neurology Division, Neurosciences Department, Hospital de Santa Maria, Lisbon, Portugal.

Reprints: Isabel Sampaio, MD, Rua Cidade de Rabat n° 52 5° esq, 1500 Lisboa, Portugal (e-mail: i_sampaio@yahoo.com).

© 2011 Lippincott Williams & Wilkins, Inc.