Thrombolysis in Pediatric Stroke Study

Rivkin, Michael J.; deVeber, Gabrielle; Ichord, Rebecca; Kirton, Adam; Chan, Anthony; Hovinga, Collin A.; Gill, Joan Cox; Szabó, Anikó; Hill, Michael D.; Scholz, Kelley; Amlie‐Lefond, Catherine

doi:10.1161/strokeaha.114.008210

Cited by 209 publications

(173 citation statements)

References 43 publications

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“…It was terminated early, however, due to insufficient enrollment. 9 Delay in the diagnosis of PAIS is another universal problem. Studies from developed countries have revealed that the mean time from the onset of symptoms to initial neuroimaging for pediatric stroke ranges from 8.8 to 16 hours.…”

mentioning

confidence: 99%

Child Neurology: Childhood basilar artery occlusion and stroke

2017

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mentioning

confidence: 99%

Child Neurology: Childhood basilar artery occlusion and stroke

2017

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“…Although the guidelines are still missing, some stroke centres are planning to define the safety guidelines for rt-PA administration in children with AIS (ref. 46 ). The interval for rt-PA administration (4.5 h from onset of clinical symptoms) and the dosage (0.9 mg/kg, 10% as a bolus) are derived from the adult studies and are nowadays considered appropriate 7 .…”

Section: Discussionmentioning

confidence: 99%

Ischemic stroke in paediatrics - narrative review of the literature and two cases

Klučka¹,

Štourač²,

Štoudek³

et al. 2017

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Stroke is a rare condition in childhood with an estimated incidence of between 1.3-13/100.000 patients. Clinical manifestation and risk factors for paediatric stroke are different from those of adults. The uncommon incidence, age-associated difference and plethora of clinical symptoms make the diagnosis of such strokes extremely difficult and often delayed. The history and clinical examination should point to diseases or predisposing factors. Neuroimaging (DWI MR) is the golden standard for diagnosis of paediatric stroke and other investigations can be considered according to the clinical condition. Despite advances in paediatric stroke research and clinical care, questions remain unanswered regarding acute treatment, secondary prevention and rehabilitation. The treatment recommendations are mainly extrapolated from studies on adult populations. In the review authors summarized the clinical characteristics and diagnostic steps for stroke in children/adolescents based on the most recent international guidelines and practical directions for recognising and managing the child/adolescent with stroke in paediatric emergency. In the two case reports, we describe the clinical course in both stroke patients.

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“…Reported thrombolysis rates in children are very small from 0.7-2% [1,11,12]. The challenges associated with site recruitment and patient screenings were described.…”

Section: Discussionmentioning

confidence: 99%

“…The challenges associated with site recruitment and patient screenings were described. Only 1 patient was enrolled out of 93 screened and 46% did have an ischemic stroke [1]. Exclusion criteria reported included moyamoya arteriopathy, anticoagulation, malignancy, recent strokes, delayed recognition and treatment times, and stroke severity NIHSS < 6 [1].…”

Section: Discussionmentioning

confidence: 99%

“…To summarize, children can have a stroke and it is important to raise awareness about stroke recognition, treatment options, rehabilitation, secondary prevention, patient selection and eligibility, collaboration amongst participating specialties like EMS, emergency medicine, adult and pediatric neurology, radiology, and adapting stroke systems of care to include children and even potentially becoming a primary pediatric stroke center based on the criteria established by the TIPS study [1,8]. The initial steps should include the formation of a pediatric acute stroke response team and protocols, and preferable access to MRI for emergency brain imaging [1,8,13].…”

Section: Discussionmentioning

confidence: 99%

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