Modern hyperacute reperfusion therapies including intravenous thrombolysis and mechanical thrombectomy have transformed the management of arterial ischemic stroke (AIS) in adults. Multiple randomized clinical trials have demonstrated that these therapies enable remarkable improvements in clinical outcome for properly selected patients with AIS. Because pediatric patients were excluded from predicate clinical trials, there is a conspicuous lack of data to guide selection of therapies and inform age-adjusted and pathology-oriented treatment modifications for children. Specifically, technical guidance concerning treatment eligibility, drug dosing, and device implementation is lacking. This review aims to outline important features that differentiate pediatric AIS from adult AIS and provide practical strategies that will assist the stroke specialist with therapeutic decision making.
Keyphrases
- emergency department
- clinical trial
- atrial fibrillation
- decision making
- young adults
- cerebral ischemia
- acute ischemic stroke
- acute myocardial infarction
- healthcare
- primary care
- pulmonary embolism
- electronic health record
- low dose
- combination therapy
- subarachnoid hemorrhage
- replacement therapy
- big data
- data analysis
- phase iii