Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke

We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to 3. Computed tomography angiogram at 24 hours showed recanalization of the occluded vessel with no evidence of intracranial hemorrhage. Stroke Scale score at discharge was 3, with modified Rankin Scale scores at discharge of 1 and at 90 days of 0. This case highlights the importance of magnetic resonance imaging in diagnosing pediatric acute ischemic stroke and suggests consideration of thrombolysis in select confirmed pediatric stroke cases. However, a rigorous evidence base is lacking, and clinical trials have not been successful in recruiting patients.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

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Publication date: Available online 28 March 2020Source: Materials Today: ProceedingsAuthor(s): S. Godwin Barnabas, S. Valai Ganesh, V. Sivakumar, P. Muthukumar, A. Dhinesh Raja, K. Hariharan
Source: Materials Today: Proceedings - Category: Materials Science Source Type: research
Publication date: Available online 28 March 2020Source: Journal of Clinical NeuroscienceAuthor(s): Akemi Hioka, Yoshiteru Tada, Keiko Kitazato, Naoki Akazawa, Yasushi Takagi, Shinji Nagahiro
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Authors: Nakata E, Sugihara S, Sugawara Y, Nakahara R, Furumatsu T, Tetsunaga T, Kunisada T, Nakanishi K, Akezaki Y, Ozaki T Abstract Malignant spinal cord compression (MSCC) is a serious complication of cancers. The present study aimed to establish a multidisciplinary treatment system for urgent magnetic resonance imaging (MRI) and referral to orthopedists in order to prevent neurological deficits caused by MSCC. In the present study, the extent to which this system achieved early diagnosis and treatment and prevented MSCC-caused neurological deficits was examined. The records from patients with neurological defic...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
CONCLUSION: In LCC, the clinical spectrum is largely heterogeneous and the course of the disease appears highly variable in contrast to other hereditary cerebral small vessel diseases. PMID: 31521395 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous t...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Discussion-Local manifestations of snake bite are soft-tissue swelling from edema, necrosis, and hemorrhage. Common long-term sequelae of envenomation is soft-tissue atrophy distal to the bite, particularly in the digits.-Systemic signs and symptoms after a venomous snake bite are due to anticoagulant/procoagulant activity or neurotoxicity. Cerebral hypoxia can occur due to hypotensive shock that may accompany some snake bite envenomations. Neuromuscular disorders with damage of the peripheral nervous system can with blockage of synaptic transmission, at either presynaptic or postsynaptic levels.Common neuro...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs
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Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Patient Presentation A 5-month-old male came to clinic for his health supervision visit and followup from his neonatal intensive care stay. He was born prematurely at 28 weeks gestation and his stay was complicated by a right sided Grade III intraventricular hemorrhage, a left-sided Grade IV intraventricular hemorrhage, neonatal seizures, respiratory distress and bronchopulmonary dysplasia, retinopathy of prematurity, acute kidney injury that had resolved, possible necrotizing enterocolitis incidents x 2, and herpes simplex encephalitis. He was on home oxygen, a nasogastric feeding tube because of aspiration risk and mult...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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Source: Neurology - Category: Neurology Authors: Tags: Neurocritical Care: Clinical Science and Therapeutics Source Type: research
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