Acute ischaemic stroke management with thrombolysis in paediatric patients: a comprehensive review of the literature

Acute ischaemic stroke (AIS) is a syndrome that is mostly observed in the adult population. However, substantial literature exists describing this clinical syndrome in children. The current standard of care, according to most guidelines, recommends treatment with 5mg/kg aminosalicylic acid, followed by unfractionated heparin or low-molecular-weight heparin. Due to insufficient validated clinical trial data, thrombolytic therapy is not currently recommended for paediatric patients presenting within the first four-and-a-half-hours; this is the same for the adult population, provided there are no contraindications. This literature review aims to compile evidence from previously published literature along with examples from case reports supporting the use of thrombolysis in paediatric patients who have suffered an AIS. The findings and study designs from multiple clinical trials documenting the use of thrombolysis in paediatric AIS have been included in this review.