Related Experiment Video
Updated: May 15, 2026
Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Investigation and management of childhood stroke
1is a Professor in Paediatric Neurology at the Neurosciences Unit, University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH and Southampton General Hospital, Southampton SO16 6YD, UK.
Insights
Pediatric stroke, a serious neurological emergency, requires prompt diagnosis due to high risks. Early intervention with imaging, and treatments like anticoagulation or aspirin, can improve outcomes for affected children.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Emergency Medicine
Background:
- Childhood stroke presents with neurological symptoms like hemiparesis, seizures, and coma.
- Vascular causes are common but may not be apparent on initial CT scans.
- Childhood stroke carries significant mortality, morbidity, and a high risk of recurrence.
Purpose of the Study:
- To emphasize the importance of acute diagnosis in pediatric stroke.
- To review diagnostic and therapeutic strategies for childhood stroke.
- To highlight the challenges and benefits of various interventions.
Main Methods:
- Review of diagnostic modalities including venography, arteriography, CT, and MRI.
- Discussion of acute management strategies: surgical decompression, thrombolysis, anticoagulation.
- Consideration of long-term management including aspirin and nutritional support.
Main Results:
- Diagnostic imaging (venography, arteriography) is crucial despite radiation or anesthesia concerns.
- Surgical decompression can be life-saving for both ischemic and hemorrhagic stroke.
- Thrombolysis is rarely feasible due to time constraints but may apply in specific posterior circulation cases.
- Anticoagulation is beneficial for venous sinus thrombosis and dissection.
- Aspirin is recommended for arterial ischemic stroke to reduce recurrence.
Conclusions:
- Prompt diagnosis and appropriate management are critical for improving outcomes in pediatric stroke.
- A multi-faceted approach involving advanced imaging and tailored medical or surgical interventions is necessary.
- Addressing underlying causes like nutritional deficiencies is also important for comprehensive care.
Abstract:
It is now clear that a number of paediatric emergencies with a neurological presentation, including hemiparesis, visual loss, seizures and coma, commonly have a vascular basis which may not be obvious on CT scan. Although many children do well, as there is significant mortality as well as morbidity for childhood stroke, in addition to a high risk for recurrence, making a diagnosis in the acute phase important. Venography and arteriography (including the neck vessels if the intracranial vessels are normal) are usually indicated despite the problems i.e. contrast CT requires a high dose of radiation while emergency MR usually requires anaesthesia and conventional arteriography carries a small risk of stroke. Surgical decompression may be life-saving in ischaemic as well as haemorrhagic stroke. It is unusual for children with anterior circulation stroke to be triaged quickly enough (<4.5 h) for thrombolysis but this may occasionally be appropriate in posterior circulation occlusion associated with coma, where the time window is longer (<12 h). Anticoagulation carries relatively low risk and may be of benefit for children with venous sinus thrombosis (acutely and when at risk subsequently) or extracranial dissection. Aspirin to attempt to reduce the recurrence risk is appropriate in the medium term for the majority of patients with arterial ischaemic stroke. Iron and B vitamin deficiencies should be excluded or treated.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
01:17Hemorrhagic Stroke l: Introduction
01:29Hemorrhagic Stroke ll: Pathophysiology
01:29Stroke: Introduction and Types
01:15Ischemic Stroke ll: Pathophysiology
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...