Intra-arterial thrombolysis of a distal internal carotid artery occlusion in an adolescent.
BACKGROUND
This article describes the first reported case of an adolescent being treated with intra-arterial urokinase for a distal internal carotid artery occlusion.


METHODS
A 15-year-old male presenting with an acute ischemic stroke caused by a distal internal carotid artery occlusion was treated with intra-arterial urokinase at 5 hours and 45 minutes after symptom onset.


RESULTS
The artery completely recanalized, and the patient improved significantly from an admission National Institutes of Health Stroke Scale (NIHSS) score of 28 to a NIHSS score of 8 at a 2.5-month follow-up, despite an asymptomatic intraparenchymal hemorrhage.


CONCLUSIONS
This article reviews the only two reported cases of intravenous thrombolysis and three cases of intra-arterial thrombolysis in children with ischemic stroke and suggests that thrombolytic therapy should be considered a treatment option in selected pediatric patients with stroke, especially in adolescents who are generally treated as young adults.
Bourekas
Eric C
EC
Department of Radiology, The Ohio State University College of Medicine, Columbus, OH 43210, USA. bourekas-1@medctr.osu.edu
Slivka
Andrew P
AP
Casavant
Marcel J
MJ
D000293:Adolescent; D000367:Age Factors; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy; D016893:Carotid Stenosis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D010960:Plasminogen Activators / Q000008:administration & dosage*; D020521:Stroke / Q000188:drug therapy / Q000209:etiology; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator