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1- Multiple Sclerosis Research Center, Sina hospital, Tehran University of Medical Sciences, Tehran, Iran
2- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
3- Department of Neurology, Yale University, New Haven, CT, USA
4- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran , alirezabaratloo@yahoo.com
Abstract:   (122 Views)
Context: Based on current literature, there is no consensus regarding the proper emergency management of pediatric acute ischemic stroke (P-AIS); and there are lots of considerable controversies in this regard. Therefore, the current review was conducted to provide a more comprehensive discussion in this topic.
Evidence acquisition: The search was conducted using terms “pediatrics”, “stroke” and “recombinant tissue plasminogen activator” in PubMed database. English language papers on management of P-AIS published after 2000 were selected. A critical appraisal was performed in an expert panel to summarize the findings and make them applicable. Finally, the extracted data were categorized in subheadings and the manuscript was prepared.
Results: There are limited evidence on the topic; all extracted findings are categorized as follows: Etiology and the underlying diseases, clinical presentations, diagnosis, management (thrombolytic therapy and thrombectomy) and outcome.
Conclusion: It seems that although thrombolytic therapy is recommended in P-AIS, but since most of the cases are diagnosed outside the therapeutic window, this treatment is practically impossible, so they are candidate for mechanical interventions. On the other hand, proper device may not be available to fit the size of younger childchr('39')s vasculature.Context: Based on current literature, there is no consensus regarding the proper emergency management of pediatric acute ischemic stroke (P-AIS); and there are lots of considerable controversies in this regard. Therefore, the current review was conducted to provide a more comprehensive discussion in this topic.
Evidence acquisition: The search was conducted using terms “pediatrics”, “stroke” and “recombinant tissue plasminogen activator” in PubMed database. English language papers on management of P-AIS published after 2000 were selected. A critical appraisal was performed in an expert panel to summarize the findings and make them applicable. Finally, the extracted data were categorized in subheadings and the manuscript was prepared.
Results: There are limited evidence on the topic; all extracted findings are categorized as follows: Etiology and the underlying diseases, clinical presentations, diagnosis, management (thrombolytic therapy and thrombectomy) and outcome.
Conclusion: It seems that although thrombolytic therapy is recommended in P-AIS, but since most of the cases are diagnosed outside the therapeutic window, this treatment is practically impossible, so they are candidate for mechanical interventions. On the other hand, proper device may not be available to fit the size of younger childchr('39')s vasculature.
Full-Text [PDF 1522 kb]   (42 Downloads)    
Type of Study: Review Article | Subject: Neurology
Received: 2020/03/11 | Accepted: 2020/09/24

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