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Thrombolytics in Pediatric Stroke: Imaging Modalities

Katherine Au, Dept. of Biomedical Engineering, with Dr. Bisi Hollist, Inova Neuroscience and Spine Institute

We report the potential danger associated with an initial neuroimaging-negative cerebral ischemia in pediatrics. For patients who present with clinical features suggestive of acute ischemic stroke but have an alternative diagnosis, there is concern of utilizing thrombolysis. Due to the short time window from symptom onset to treatment, a thorough history and neurologic examination, along with diagnostic imaging and blood tests are important for diagnosis and timely treatment. We present a case of a 14-year old female with a history of thalamic stroke who presented with neurological symptoms consistent with acute stroke. An MRI of her brain was indeterminate and showed no frank evidence of cerebral infarction. Further inspection showed an area of restricted diffusion which clinically correlated to her symptoms. There was no evidence of vessel wall irregularities, high grade stenosis or dissection. This patient was administered intravenous tPA over the course of 1 hour and her symptoms resolved.

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Dr. Bisi Hollist


Virginia Commonwealth University. Undergraduate Research Opportunities Program

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Thrombolytics in Pediatric Stroke: Imaging Modalities