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This tool is educational and informational. It does not replace clinical judgment. Verify pediatric IVT/EVT eligibility, weight-based dosing against the cited source before acting.
Not prospectively validated. No clinical tool replaces bedside assessment.
This tool qualifies as non-device clinical decision support under the January 2026 FDA CDS guidance (21st Century Cures Act §3060). It does not acquire or analyze patient data, it displays the basis for its recommendations, it enables independent clinician review, and it is intended for use by trained healthcare professionals.
This runs entirely in your browser; we store nothing. Even so, enter only clinical data (age, vitals, exam findings) -- not names, MRNs, or other identifiers.
Tarvinder Singh, MD -- Vascular Neurologist. March 2026.
Pediatric Stroke
IVT and EVT review for pediatric acute ischemic stroke (AHA/ASA 2026 covers 28d-18y; this tool is validated 2-17 with tier-aware routing for younger / older edges).
Pediatric Stroke Advisory
Pediatric stroke is rare. These recommendations are based on 2026 inaugural pediatric guidelines. Adult trial populations may not generalize to children. Always involve pediatric neurology and neurosurgery.
Blood pressure (pediatric)
- Pre-IVT: no adult 185/110 threshold -- judge against age- and size-indexed norms; involve pediatric neurology before thrombolysis even when adult cutoffs would read eligible.
- Post-IVT: target SBP <180 mmHg (not the adult 180/105); severe hypertension in the first 24 hours after alteplase is the population where the sICH signal is strongest.
Sources: AHA/ASA 2019 scientific statement on stroke in neonates and children; AHA/ASA 2026 acute ischemic stroke guideline; TIPS trial (Bernard et al., Stroke 2014 -- safety-only pediatric alteplase series, trial halted for slow enrollment).
Step 1a: Age Tier
Triage Fork: Known Etiology?
Etiology pendingPick the etiology row that matches the working diagnosis. SCD, CSVT, and Moyamoya override standard IVT logic. Standard means all three are actively excluded; Unknown means etiology has not yet been established and the standard pathway is provisional.
Step 1b: Time, Imaging, And Treatment Gates
BP < 185/110 After Treatment Attempt?
This is the only BP question the IVT gate needs here. Use Yes once the pressure is below threshold after treatment or clearly controllable with IV antihypertensives.
EVT And Evidence Refinement
Pre-stroke mRS and ASPECTS for EVT candidacy.
0-10 (Alberta Stroke Program Early CT Score).
What to enter next
Recommendations, dosing, and matched trial evidence appear after intake data.