The risks and safety of clopidogrel in pediatric arterial ischemic stroke.

BACKGROUND AND PURPOSE The purpose of this study was to determine safety and tolerability of clopidogrel in children with arterial ischemic stroke (AIS). Clopidogrel is the alternative antiplatelet medication when aspirin is not tolerated or fails. The possible risks and safety of clopidogrel in children with AIS have not been assessed. METHODS This is a prospective consecutive cohort study of children with AIS who were started on clopidogrel. Seventeen children were included. RESULTS Two children developed subdural hematomas while on clopidogrel in conjunction with aspirin. Two others had headache or hand numbness. No other side effects like rash or gastrointestinal upsets were reported. CONCLUSIONS We found clopidogrel to be relatively well tolerated in the pediatric population. In combination with aspirin and in the presence of other risk factors, intracranial bleeding may be seen.