Article

Treatment of arterial ischemic stroke in children

Children's National Medical Center, Department of Neurology, Washington, DC 20010, USA.
Expert Review of Neurotherapeutics (Impact Factor: 2.83). 04/2007; 7(4):383-92. DOI: 10.1586/14737175.7.4.383
Source: PubMed

ABSTRACT Stroke is a rare but increasingly recognized disorder in children. Current therapies for arterial ischemic stroke include thrombolytic, antithrombotic and antiplatelet agents, blood transfusion and surgery. Adult studies, pediatric case studies and expert opinion form the basis for these treatment strategies. Thrombolytic agents are increasingly used but, as in adults, the majority of arterial ischemic strokes in children are treated with antiplatelet and antithrombotic agents. Sickle-cell patients, a distinct subset of the pediatric stroke population, are treated primarily with transfusion therapy. Pediatric arterial ischemic stroke studies are needed to determine the most appropriate course of treatment. An international study is currently in progress to formally study the incidence, risk factors, treatment strategies and outcomes of stroke in children.

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    • "Fever should be controlled. Hyperthermia has been associated with increased secondary injury in multiple animal models of stroke [164]. Seizures should be aggressively treated. "
    Advances in Pediatrics 01/2009; 56(1):271-99. DOI:10.1016/j.yapd.2009.08.003
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    • "One study showed 1.6% of pediatric AIS patients admitted between 2000 and 2003 received thrombolytic therapy.1 The children receiving thrombolytics had significantly higher medical costs, were less likely to be discharged home and had higher overall mortality rates.1 Shortcomings of these findings were noted, including the small sample size and unknown severity of any of the patients at the time of presentation. Conversely, several case reports have been published showing potential benefits using thrombolytic therapy in children, including success stories across a wide age range and administration of thrombolytics well outside of the standard three-hour window used in adults.11,12 "
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