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Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

[Thrombolysis in arterial cerebral infarction in children]

Ulrike Waje-Andreassen1, Lars Thomassen, Anen Aarli

  • 1Nevrologisk avdeling, Haukeland universitetssykehus, 5053 Bergen, Norway. ulrike.andreassen@helse-bergen.no

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|November 10, 2009
PubMed

Insights

Arterial cerebral infarction in children is rare but serious. While thrombolysis is standard for adults, its use in children is debated due to limited evidence, though case reports exist.

Area of Science:

  • Pediatric Neurology
  • Cerebrovascular Diseases
  • Thrombolytic Therapy

Background:

  • Arterial cerebral infarction incidence in children is 1-2/100,000 per year.
  • Thrombolysis is standard for adults but controversial in pediatric stroke.
  • This paper reviews thrombolysis documentation for pediatric arterial cerebral infarction.

Purpose of the Study:

  • To provide an overview of documented thrombolysis treatments for arterial cerebral infarction in children.
  • To summarize current evidence and clinical considerations for pediatric stroke thrombolysis.

Main Methods:

  • Non-systematic literature search of PubMed.
  • Inclusion of own clinical experience in treating young adults with cerebral infarction.

Main Results:

  • Common causes in Western countries include cardiac disease, interventions, and infections.
  • Initial treatment mirrors adult protocols: rapid admission and advanced imaging (MRI/MRA).
  • No randomized controlled trials exist for pediatric thrombolysis; it's generally not recommended due to lack of evidence, but is used in practice.

Conclusions:

  • Thrombolysis should be considered in children under 18 if it's the sole contraindication, given the risk of severe disability.
  • Establishing an international registry for pediatric thrombolysis treatment is recommended.
Abstract

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