Imaging in childhood arterial ischaemic stroke

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Vascular Neurology

Background:

• Arterial ischaemic stroke (AIS) is a significant cause of childhood mortality and long-term disability, contrary to common misconceptions.
• Established adult stroke risk factors are uncommon in pediatric AIS; instead, diverse etiologies like arteriopathies, sickle cell disease, and genetic disorders are implicated.
• Recurrence rates can reach 25%, and two-thirds of affected children experience lasting disabilities, highlighting the critical need for effective management.

Purpose of the Study:

• To provide an overview of childhood arterial ischaemic stroke (AIS).
• To emphasize the crucial role of neuroimaging in diagnosing and managing pediatric AIS.
• To discuss controversies in etiology and their impact on stroke management strategies.

Main Methods:

• Review of current literature on childhood arterial ischaemic stroke (AIS).
• Focus on the diagnostic utility of acute and delayed vascular imaging in pediatric patients.
• Discussion of various underlying etiologies and their association with AIS.

Main Results:

• Childhood AIS affects 2-6/100,000 children annually and is a leading cause of pediatric death.
• Pediatric AIS is linked to a wide range of conditions, often with multiple coexisting risk factors.
• Neuroimaging is pivotal for diagnosis, management, and risk stratification in childhood AIS.

Conclusions:

• Childhood arterial ischaemic stroke (AIS) is a critical pediatric health issue requiring comprehensive diagnostic approaches.
• Understanding the diverse etiologies of pediatric AIS is essential for appropriate clinical management.
• Advanced vascular imaging techniques are indispensable for accurate diagnosis, treatment, and prognosis assessment in childhood AIS.