Superselective Intra-Arterial Thrombolysis for Acute Cardioembolic Stroke in a Child with Idiopathic Dilated Cardiomyopathy

Abstract

We describe a case of cardioembolic dominant hemisphere internal carotid artery occlusion in a child with idiopathic dilated cardiomyopathy. The patient was subjected to superselective local intra-arterial thrombolysis using recombinant tissue plasminogen activator (Alteplase; Actilyse®). In presence of good collateral flow local intra-arterial thrombolysis prevented a major dominant hemisphere ischaemic stroke, although post-interventional computed tomographic scans disclosed haemorrhagic conversion in the left corpus striatum. Forty eight months after ischaemic stroke and thrombolysis the patient is ambulatory with a moderate neurologic deficit.