Thrombolysis in Pediatric Stroke Study

5] The perceived high potential for benefit after treatment justified assumption of risk for intracranial hemorrhage (ICH) after its use. 9 Because in adults, the risk of hemorrhage after tPA use was thought to be related to infarct volume; this principle was assumed for children. The known developmental trajectory of the fibrinolytic system includes lower levels of endogenous tPA and higher levels of plasminogen activator inhibitor-1 in young children than are found in adults and warranted a dose-finding study beginning at doses lower than that used in adults with incremental increase through the currently used adult dose of 0.9 mg/kg and careful assessment of tPA pharmacokinetics. urrently, information on children treated with tPA consists of case reports, small case series, and hospital database documentation. Best practice for the treatment of children with acute stroke has received little rigorous study. Clinical approach varies widely among centers and reflects a dearth of research on which to base treatment protocols. ]