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Related Experiment Videos

Stroke in Children.

Roach1

  • 1Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75235, USA.

Current Treatment Options in Neurology
|November 30, 2000
PubMed
Summary
This summary is machine-generated.

Identifying and treating stroke risk factors in children is crucial. Early evaluation for conditions like arteriovenous malformations and utilizing transcranial Doppler for sickle cell disease can prevent future strokes.

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Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Hematology

Background:

  • Stroke risk factors in children require thorough investigation for effective management.
  • Cumulative effects of risk factors necessitate comprehensive evaluation, even in children with known conditions.
  • Congenital vascular anomalies like arteriovenous malformations (AVMs) and aneurysms are treatable causes of pediatric stroke.

Purpose of the Study:

  • To review current strategies for identifying and managing stroke risk factors in pediatric patients.
  • To highlight the importance of cerebral angiography in diagnosing vascular anomalies.
  • To discuss the role of blood transfusions and transcranial Doppler (TCD) in managing sickle cell disease-related stroke risk.

Main Methods:

  • Cerebral angiography recommended for unexplained pediatric stroke.

Related Experiment Videos

  • Periodic blood transfusions and iron chelation for sickle cell disease.
  • Transcranial Doppler (TCD) for stroke risk screening in sickle cell disease.
  • Anticoagulant, antiplatelet, and thrombolytic therapies adapted from adult protocols.

    • Main Results:

    • Cerebral angiography identifies treatable vascular anomalies in over one-third of children with intraparenchymal hemorrhage.
    • Evidence supports periodic blood transfusions for preventing cerebral infarction in sickle cell disease, requiring indefinite duration and iron chelation.
    • TCD is highly predictive of stroke risk in sickle cell disease, justifying routine screening.
    • Anticoagulants (heparin, warfarin) used for sinovenous thrombosis and arterial dissection; thrombolysis for acute infarction is infrequent due to late presentation.
    • Aspirin is commonly used as an antiplatelet agent, despite lack of definitive trials, balancing stroke risk against the rare risk of Reye's syndrome.

    Conclusions:

    • Early identification and treatment of pediatric stroke risk factors, including vascular anomalies and those in sickle cell disease, are essential.
    • Cerebral angiography and TCD are vital diagnostic and screening tools.
    • Chronic transfusions for sickle cell disease require careful management of iron toxicity.
    • Therapeutic approaches for pediatric stroke often adapt adult protocols due to limited pediatric-specific trials.