Introduction: Stroke is a potential risk to everyone, including children. The incidence of paediatric stroke is rare,up to 13 cases per 100,000, but can produce significant morbidity and mortality.Most management recommendations for acute stroke in children are extrapolated from adults,the guidelines suggest that rtPA may be considered in a select group of children. We describe 3 cases of thrombolysis in children from a database of 334 adult stroke patients. Methods: From the 310 patients treated with rtPA within 3 hrs,3 strokes were children, aged 9, 12 and 15 years respectively. Informed consent was obtained for all patients.Inclusion and exclusion criteria were observed strictly.We used the recommendations from the TIPS study protocol. Results: The 3 children were treated with a low dose of tPA according to weight. The NIHSS was 9, 11 and 14 at time 0 respectively. The NIHSS at 24 hrs was 0 for the children aged 12 and 15, and 3 for the child aged 9. At 3 months follow up the child aged 9 showed a little trouble with speech, while the 2 others recovered completely. A cause of stroke was found in two of the 3 children. Conclusion: The safety and the efficacy of thrombolysis after acute stroke in children has not been established. These 3 cases,showed safety and good outcomes, but the numbers are too small to be significant. There is a need to collect more cases worldwide in order to establish stronger evidence for providing optimal care.
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