Ying Zhang, Chang-Xing Jiang, Hong-Gang Wang, Hao-Ran Gao, Dan Li, Lei Zhao, Li-Hong Gao
{"title":"静脉溶栓和血管内桥注射替罗非班治疗小儿急性缺血性脑卒中1例。","authors":"Ying Zhang, Chang-Xing Jiang, Hong-Gang Wang, Hao-Ran Gao, Dan Li, Lei Zhao, Li-Hong Gao","doi":"10.1186/s12883-025-04358-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) in pediatric patients is a significant contributor to neurological impairment and long-term disability. Due to the absence of specific pediatric treatment guidelines, management strategies are frequently adapted from adult protocols. This report details the application of intravenous tenecteplase thrombolysis, endovascular bridging therapy, and tirofiban in treating a pediatric case of AIS.</p><p><strong>Case description: </strong>A pediatric patient presented with AIS involving the left limb, lasting 2.5 h. The stroke occurred during physical activity without loss of consciousness or seizures. Head magnetic resonance imaging (MRI) combined with clinical manifestations confirmed the diagnosis of acute cerebral infarction. Intravenous thrombolytic therapy using tenecteplase was initiated in the ultra-early phase of infarction. Subsequent cerebral angiography revealed occlusion of the superior trunk of the right middle cerebral artery. Three-dimensional rotational imaging identified multiple aneurysms at its bifurcation. A targeted intra-arterial injection of tirofiban (6 mL) was administered to stabilize plaque and enhance blood flow. The patient underwent 11 days of antiplatelet therapy and supportive care. At the 90-day postoperative follow-up, notable recovery of limb function was observed.</p><p><strong>Conclusions: </strong>Pediatric AIS exhibits variable clinical manifestations, requiring head MRI for definitive diagnosis. Early initiation of intravenous thrombolysis with tenecteplase, combined with targeted intra-arterial tirofiban injection, demonstrates potential as a safe and effective therapeutic approach in pediatric ischemic stroke management.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"348"},"PeriodicalIF":2.2000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376366/pdf/","citationCount":"0","resultStr":"{\"title\":\"Intravenous tenecteplase thrombolysis and endovascular bridging intra-arterial tirofiban injection therapy in a pediatric case of acute ischemic stroke.\",\"authors\":\"Ying Zhang, Chang-Xing Jiang, Hong-Gang Wang, Hao-Ran Gao, Dan Li, Lei Zhao, Li-Hong Gao\",\"doi\":\"10.1186/s12883-025-04358-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute ischemic stroke (AIS) in pediatric patients is a significant contributor to neurological impairment and long-term disability. Due to the absence of specific pediatric treatment guidelines, management strategies are frequently adapted from adult protocols. This report details the application of intravenous tenecteplase thrombolysis, endovascular bridging therapy, and tirofiban in treating a pediatric case of AIS.</p><p><strong>Case description: </strong>A pediatric patient presented with AIS involving the left limb, lasting 2.5 h. The stroke occurred during physical activity without loss of consciousness or seizures. Head magnetic resonance imaging (MRI) combined with clinical manifestations confirmed the diagnosis of acute cerebral infarction. Intravenous thrombolytic therapy using tenecteplase was initiated in the ultra-early phase of infarction. Subsequent cerebral angiography revealed occlusion of the superior trunk of the right middle cerebral artery. Three-dimensional rotational imaging identified multiple aneurysms at its bifurcation. A targeted intra-arterial injection of tirofiban (6 mL) was administered to stabilize plaque and enhance blood flow. The patient underwent 11 days of antiplatelet therapy and supportive care. At the 90-day postoperative follow-up, notable recovery of limb function was observed.</p><p><strong>Conclusions: </strong>Pediatric AIS exhibits variable clinical manifestations, requiring head MRI for definitive diagnosis. Early initiation of intravenous thrombolysis with tenecteplase, combined with targeted intra-arterial tirofiban injection, demonstrates potential as a safe and effective therapeutic approach in pediatric ischemic stroke management.</p>\",\"PeriodicalId\":9170,\"journal\":{\"name\":\"BMC Neurology\",\"volume\":\"25 1\",\"pages\":\"348\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376366/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12883-025-04358-3\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-025-04358-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Intravenous tenecteplase thrombolysis and endovascular bridging intra-arterial tirofiban injection therapy in a pediatric case of acute ischemic stroke.
Background: Acute ischemic stroke (AIS) in pediatric patients is a significant contributor to neurological impairment and long-term disability. Due to the absence of specific pediatric treatment guidelines, management strategies are frequently adapted from adult protocols. This report details the application of intravenous tenecteplase thrombolysis, endovascular bridging therapy, and tirofiban in treating a pediatric case of AIS.
Case description: A pediatric patient presented with AIS involving the left limb, lasting 2.5 h. The stroke occurred during physical activity without loss of consciousness or seizures. Head magnetic resonance imaging (MRI) combined with clinical manifestations confirmed the diagnosis of acute cerebral infarction. Intravenous thrombolytic therapy using tenecteplase was initiated in the ultra-early phase of infarction. Subsequent cerebral angiography revealed occlusion of the superior trunk of the right middle cerebral artery. Three-dimensional rotational imaging identified multiple aneurysms at its bifurcation. A targeted intra-arterial injection of tirofiban (6 mL) was administered to stabilize plaque and enhance blood flow. The patient underwent 11 days of antiplatelet therapy and supportive care. At the 90-day postoperative follow-up, notable recovery of limb function was observed.
Conclusions: Pediatric AIS exhibits variable clinical manifestations, requiring head MRI for definitive diagnosis. Early initiation of intravenous thrombolysis with tenecteplase, combined with targeted intra-arterial tirofiban injection, demonstrates potential as a safe and effective therapeutic approach in pediatric ischemic stroke management.
期刊介绍:
BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.