Neurocritical Care

, Volume 2, Issue 2, pp 179–182

Intra-arterial thrombolysis of a distal internal carotid artery occlusion in an adolescent

  • Eric C. Bourekas
  • Andrew P. Slivka
  • Marcel J. Casavant
Practical Pearls


Introduction: This article describes the first reported case of an adolescent being treated with intra-arterial urokinase for a distal internal carotid artery occlusion.

Methods: A 15-year-old male presenting with an acute ischemic stroke caused by a distal internal carotid artery occlusion was treated with intra-arterial urokinase at 5 hours and 45 minutes after symptom onset.

Results: The artery completely recanalized, and the patient improved significantly from an admission National Institutes of Health Stroke Scale (NIHSS) score of 28 to a NIHSS score of 8 at a 2.5-month follow-up, despite an asymptomatic intraparenchymal hemorrhage.

Conclusion: This article reviews the only two reported cases of intravenous thrombolysis and three cases of intra-arterial thrombolysis in children with ischemic stroke and suggests that thrombolytic therapy should be considered a treatment option in selected pediatric patients with stroke, especially in adolescents who are generally treated as young adults.

Key Words

Thrombolysis intra-arterial pediatric urokinase stroke 


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Copyright information

© Humana Press Inc. 2005

Authors and Affiliations

  • Eric C. Bourekas
    • 3
  • Andrew P. Slivka
    • 1
  • Marcel J. Casavant
    • 2
  1. 1.Department of NeurologyThe Ohio State University College of MedicineColumbus
  2. 2.Department of Pediatrics and Emergency MedicineChildren’s HospitalColumbus
  3. 3.Department of RadiologyThe Ohio State University Medical CenterColumbus

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