[Thrombolysis in arterial cerebral infarction in children].
BACKGROUND
After the neonatal period, the incidence of arterial cerebral infarction is 1-2/100 000 children/year. Thrombolysis in cerebral stroke is recommended for adults, but is still controversial for children. The aim of this paper was to provide an overview of documentation on treatment with thrombolysis after arterial cerebral infarction in children.


METHODS
The article is based on literature identified through a non-systematic search in PubMed and own clinical experience in treating young adults with cerebral infarction.


RESULTS
In the western world cardiac disease, cardiac interventions and infections are the most important causes of cerebral infarction in children. Children with arterial cerebral infarction should initially be treated as adults, i.e. rapid admission to hospital and immediate imaging, preferably magnetic resonance imaging with diffusion and intracranial angiography. There are no randomized controlled trials of efficacy and safety of thrombolysis in cerebral infarction in children. Thrombolysis is normally not recommended for children because of the lack of scientific evidence. Nevertheless, thrombolysis is used in children with cerebral infarction and case reports are available.


CONCLUSIONS
The prospect of severe disability should lead to consideration of thrombolysis if age below 18 years is the only contraindication. Treatment of children with thrombolysis should be recorded in an international registry.
Waje-Andreassen
Ulrike
U
Nevrologisk avdeling, Haukeland universitetssykehus, 5053 Bergen, Norway. ulrike.andreassen@helse-bergen.no
Thomassen
Lars
L
Aarli
Anen
A
Kråkenes
Jostein
J
Norgård
Gunnar
G
Russell
David
D
D000293:Adolescent; D000367:Age Factors; D002544:Cerebral Infarction / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D007275:Injections, Intravenous; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator