Related Experiment Video

Updated: Jun 25, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Bacterial endocarditis in a child presenting with acute arterial ischemic stroke: should thrombolytic therapy be

Marilyn Tan1, Derek Armstrong, Catherine Birken

  • 1Department of Pediatrics, Hospital for Sick Children, Toronto, Canada.

Developmental Medicine and Child Neurology
|February 5, 2009
PubMed

Insights

Thrombolysis may be safe for children with acute ischemic stroke due to infective endocarditis (IE). A case report shows successful intra-arterial thrombolytic therapy led to neurological recovery without complications.

Area of Science:

  • Neurology
  • Cardiology
  • Pediatrics

Background:

  • Infective endocarditis (IE) typically contraindicates thrombolysis for acute ischemic stroke.
  • Childhood stroke secondary to IE is rare and poses treatment challenges.

Observation:

  • A 12-year-old female presented with acute ischemic stroke symptoms.
  • Cranial imaging revealed multiple brain lesions and left internal carotid artery occlusion.
  • Diagnosis of pneumococcal endocarditis was confirmed.

Findings:

  • The patient received intra-arterial tissue plasminogen activator (tPA) within 6 hours.
  • No hemorrhagic complications occurred post-thrombolysis or surgery.
  • Mitral valve vegetations were debrided, and the valve was repaired.
  • Follow-up imaging showed complete recanalization of the artery and significant neurological recovery.

Implications:

  • This is the first reported case of successful intra-arterial thrombolysis for childhood IE-related stroke.
  • Thrombolytic therapy may be a viable option for selected pediatric patients with IE-related ischemic stroke.
  • Careful patient selection and monitoring are crucial for safe and effective treatment.

More Related Videos

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Related Concept Videos

Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...