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Updated: Jun 2, 2026
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Published on: November 26, 2013
Systemic thrombolytic therapy alone and in combination with mechanical revascularization in acute ischemic stroke in
B Modrau1, L Sørensen, N J Bartholdy
1Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Insights
Thrombolytic therapy for acute ischemic stroke (AIS) in children is not well-established. This case report details two pediatric AIS cases, highlighting the need for tailored treatment approaches and advanced imaging for better outcomes.
Area of Science:
- Pediatric Neurology
- Neurocritical Care
- Thrombotic Disorders
Background:
- Thrombolytic therapy is generally not recommended for acute ischemic stroke (AIS) in pediatric patients.
- Published experience with thrombolytic therapy in children is limited.
Observation:
- This case report describes two pediatric patients who underwent systemic thrombolytic therapy for AIS.
- One patient also received mechanical revascularization, resulting in a favorable clinical outcome.
Findings:
- Differences in the pediatric fibrinolytic system and the diverse etiologies of AIS in childhood may preclude direct application of adult treatment guidelines.
- Multimodal imaging is crucial for clarifying AIS etiology in children.
Implications:
- Current adult guidelines for thrombolytic therapy may not be directly applicable to pediatric AIS.
- Personalized treatment strategies informed by advanced imaging are essential for optimizing outcomes in pediatric AIS.
- Further research is needed to establish evidence-based guidelines for thrombolytic therapy in pediatric AIS.
Abstract:
Thrombolytic therapy is not recommended for acute ischemic stroke (AIS) in patients under the age of 18 and published experience is limited. In this case report, we describe two children treated with systemic thrombolytic therapy. One child received additional mechanical revascularization and achieved a good clinical outcome. The differences in the fibrinolytic system and the different etiology of AIS in childhood may limit a simple extrapolation of the adult guidelines for systemic thrombolytic therapy. Acute multimodal imaging to clarify the etiology of AIS might help to select the most appropriate treatment modality.
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