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Conventional cerebral angiography in children with ischemic stroke
V Ganesan1, L Savvy, W K Chong
1Neurosciences Unit, Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
Pediatric Neurology
|February 24, 1999
Summary
Magnetic resonance angiography is highly effective for diagnosing pediatric ischemic stroke, particularly large vessel issues. Conventional angiography offers additional diagnostic value in specific cases, guiding treatment decisions.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Vascular Imaging
Background:
- Ischemic stroke in children presents diagnostic challenges.
- Conventional cerebral angiography and magnetic resonance angiography (MRA) are key imaging modalities.
- Determining the optimal role of each in pediatric ischemic stroke requires evaluation.
Purpose of the Study:
- To compare the diagnostic utility of conventional cerebral angiography and MRA in pediatric ischemic stroke.
- To assess the impact of conventional angiography on patient management.
- To propose a clinical algorithm for imaging in pediatric ischemic stroke.
Main Methods:
- Retrospective review of 46 children with ischemic stroke.
- Analysis of conventional cerebral angiograms.
- Comparison with magnetic resonance imaging and MRA findings where available.
Main Results:
- MRA was diagnostic in 25/28 patients with large vessel occlusion, stenosis, or moyamoya syndrome.
- Conventional angiography revealed abnormalities in 4/9 patients with normal MRA.
- Conventional angiography altered management in 10 patients across various vascular conditions.
Conclusions:
- MRA is a primary diagnostic tool for pediatric ischemic stroke, especially for large vessel disease.
- Conventional angiography provides crucial supplementary information and influences management in select cases.
- A proposed algorithm can optimize the use of these imaging techniques for pediatric ischemic stroke.