Related Experiment Video

Updated: May 6, 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

14.4K

Thrombolysis for children with acute ischemic stroke: a perspective from the kids' inpatient database

Amer Alshekhlee1, Thomas Geller, Sonal Mehta

  • 1Department of Neurology, Souers Stroke Institute, St. Louis University, St. Louis, Missouri; SSM Neuroscience Institutes, DePaul Health Center, St. Louis University, St. Louis, Missouri; Department of Neurology, St. George's University, Great River, New York.

Pediatric Neurology
|October 22, 2013
PubMed

Insights

Thrombolysis for pediatric acute ischemic stroke (AIS) is rarely used, with a slight increase in utilization. While risks of intracerebral hemorrhage and mortality are low, similar to adults, further research is needed for efficacy.

Area of Science:

  • Pediatric Neurology
  • Cardiovascular Research
  • Public Health

Background:

  • Thrombolysis for acute ischemic stroke (AIS) in children lacks proven efficacy and extensive safety data.
  • Limited information exists on the safety of thrombolysis in large pediatric populations.

Purpose of the Study:

  • To evaluate the safety outcomes of thrombolysis in children with AIS.
  • To analyze trends in hospital utilization of thrombolysis for pediatric AIS over a decade in the US.

Main Methods:

  • Utilized the Kids' Inpatient Database (1998-2009) to identify a cohort of children with AIS.
  • Employed multivariate logistic regression to assess factors associated with hospital mortality and intracerebral hemorrhage.
  • Applied the Cochran-Armitage test to determine linear trends in discrete variables.

Main Results:

  • A small fraction (0.7%) of 9257 AIS children received thrombolysis; treated children were older with longer hospital stays.
  • Unadjusted analysis indicated higher hospital mortality and intracerebral hemorrhage rates in the thrombolysis group.
  • Adjusted analysis revealed intracerebral hemorrhage as a predictor of mortality, but thrombolysis was not a significant predictor.

Conclusions:

  • Thrombolysis is infrequently administered for pediatric AIS, with increasing hospital utilization observed.
  • Risks of intracerebral hemorrhage and mortality associated with pediatric thrombolysis appear low, comparable to adult data.
  • Further investigation is warranted to establish the efficacy and optimize the safety of thrombolysis in children with AIS.
Abstract

Keywords:
childrenintracranial hemorrhageischemic strokeoutcomestrokethrombolysis

More Related Videos

Prehospital Thrombolysis: A Manual from Berlin05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

25.1K
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

14.4K

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
764
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...
74
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
562
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
57
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
41