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  • Title: Intra-arterial thrombolysis of a distal internal carotid artery occlusion in an adolescent.
    Author: Bourekas EC, Slivka AP, Casavant MJ.
    Journal: Neurocrit Care; 2005; 2(2):179-82. PubMed ID: 16159062.
    Abstract:
    INTRODUCTION: 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. CONCLUSION: 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.
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