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Related Concept Videos

Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...

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Updated: Jun 26, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Paediatric stroke. Who should be treated?

G Deveber1

  • 1Hospital for Sick Children Research Institute, University of Toronto, Toronto, Canada. gabrielledev@cogeco.ca

Hamostaseologie
|January 20, 2009
PubMed
Summary

Pediatric stroke guidelines now offer consistent antithrombotic treatment recommendations. Arterial ischemic stroke in children requires treatment, while newborns and cerebral sinovenous thrombosis cases have specific management strategies.

Area of Science:

  • Neurology
  • Pediatrics
  • Hematology

Background:

  • Pediatric stroke research has significantly increased over the last decade.
  • Limited studies have focused on antithrombotic safety and efficacy in children.
  • Three recent pediatric stroke guidelines integrate research and expert consensus.

Purpose of the Study:

  • To review and synthesize current treatment guidelines for pediatric stroke.
  • To outline antithrombotic treatment recommendations for different pediatric stroke types.
  • To address the safety and effectiveness of antithrombotic therapies in pediatric populations.

Main Methods:

  • Analysis of three recently published pediatric stroke guidelines.
  • Comparison of treatment recommendations for arterial ischemic stroke (AIS) and cerebral sinovenous thrombosis (CSVT).

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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  • Evaluation of antithrombotic strategies including anticoagulation and antiplatelet therapy.

    • Main Results:

    • Newborns with AIS have a low recurrence risk and rarely need antithrombotics.
    • Children with AIS have a significant recurrence risk, necessitating antithrombotic treatment unless contraindicated.
    • Anticoagulation is recommended for dissection and embolism in AIS; antiplatelet therapy for others.
    • Neonatal CSVT management involves initial anticoagulation if no hemorrhage, otherwise monitoring.
    • Children with CSVT, including those with hemorrhagic infarction, generally receive anticoagulation.

    Conclusions:

    • Current pediatric stroke guidelines provide consistent treatment recommendations for most patients.
    • Specific antithrombotic strategies are outlined for AIS and CSVT in neonates and children.
    • While further research is needed, existing guidelines offer valuable interim guidance for pediatric stroke management.