title: Ischemic stroke and excellent recovery after administration of intravenous tissue plasminogen activator.
abstract: Intravenous tissue plasminogen activator has become a mainstream treatment for ischemic hyperacute stroke in the adult population. Its safety and efficacy remain undetermined in the pediatric population. We present a teenager who was hospitalized with left-sided paralysis, and with decreased sensations on the left side. Head computed tomography indicated hyperdensity in the middle cerebral artery region, which confirmed the diagnosis of acute ischemic stroke. Her score on the National Institutes of Health stroke scale was 11. She received intravenous tissue plasminogen activator without any complications. At a follow-up visit 5 months after the stroke, the patient manifested mild apraxia in her left hand and mild expressive amusia. This case underscores the need for emergency head imaging in the pediatric population to establish a diagnosis. The excellent recovery in our patient indicates the need to establish thrombolytic treatment as an option for acute stroke in pediatric populations. It also suggests that tissue plasminogen activator can be used safely and effectively, even in pediatric populations. However, further studies are needed to establish the adequate dosage and adverse-effect profile in pediatric populations.
authors.affiliation: Department of Neurology, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298, USA.
authors.forename: Sejal V
authors.initials: SV
authors.lastname: Jain
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Morton
mesh_terms: D000293:Adolescent; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000000981:diagnostic imaging; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D010243:Paralysis / Q000209:etiology; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use*; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator