Administration of intravenous tissue plasminogen activator in a pediatric patient with acute ischemic stroke.

Intravenous tissue plasminogen activator is the only therapy approved by the US Food and Drug Administration (FDA) for the treatment of acute ischemic strokes. The National Institutes of Health (NIH)-sponsored study that led to the approval of tissue plasminogen activator to be used in acute ischemic strokes included only individuals 18 years of age and older. We report a case of a pediatric patient who suffered a dominant-hemisphere acute ischemic stroke who was treated with intravenous tissue plasminogen activator. Our patient's symptoms began to resolve 4 hours after treatment, and he had a complete recovery after 8 hours. The clinical outcome was excellent and without complications. Tissue plasminogen activator administration can be safe and effective in younger patients. Randomized, controlled, double-blind studies are needed.