Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição 4.0 Internacional (CC BY 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.
Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição 4.0 Internacional (CC BY 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.
Introduction: Pediatric stroke is a disorder that can result in morbidity and mortality. The ischemic type is the most common and has thrombolytics as the preferred therapy. Objective: To evaluate the therapeutic management and efficacy of fibrinolytics in pediatric patients with ischemic stroke. Methodology: The literature review was carried out in PUBMED, MEDLINE, Embase databases, with the descriptors “Fibrinolytic Agents”, “Thrombolytic Therapy”, “Ischemic Stroke”, “Stroke”, “Pediatrics” and “Treatment”. Included were clinical trials, randomized controlled trials, cohort, case- control, and case series in English or Portuguese published in the last 5 years. It gathered 8 articles. Results: Treatment in the acute phase and for secondary prevention in the chronic phase of pediatric stroke are antithrombotic therapies and platelet antiaggregants, commonly aspirin. Comparing the latter and low molecular weight heparin, neither has shown superiority in preventing stroke recurrence. Without good evidence, however, aspirin is indicated for idiopathic stroke and anticoagulants in cardioembolic stroke by some guidelines. In recombinant tissue plasminogen activator therapy in one paper it was suggested there is more risk for conversion to hemorrhagic events compared to untreated, but in another paper hemorrhage was not seen. There was high mortality with this therapy and higher chances of being discharged to short term hospital, skilled nursing facility or intermediate care facility. In endovascular therapy, delay in diagnosis limits its use and stroke complications did not differ between patients who did or did not undergo this therapy. Conclusion: Further studies are needed to evaluate the efficacy of fibrinolytics.
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