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Cerebrovascular disorders in childhood

Maja Steinlin1

  • 1Neuropaediatric Department, University Children's Hospital Inselspital, Bern, Switzerland.

Handbook of Clinical Neurology
|April 30, 2013
PubMed

Insights

Childhood cerebrovascular problems, including stroke, affect 5-8/100,000 children yearly. Many survivors face lifelong neurological deficits, highlighting the need for better diagnosis and treatment strategies.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Child Neurology

Background:

  • Cerebrovascular problems in children are diverse, impacting brain vascular supply.
  • Incidence ranges from 5 to 8 per 100,000 children annually.
  • Manifestations vary based on infarction location, age, and risk factors.

Purpose of the Study:

  • To review the diverse spectrum of cerebrovascular problems in children.
  • To discuss diagnostic modalities and current treatment recommendations.
  • To highlight the long-term neurological and neuropsychological sequelae.

Main Methods:

  • Review of current literature on pediatric cerebrovascular disorders.
  • Analysis of clinical presentation, risk factors, and diagnostic approaches.
  • Evaluation of treatment guidelines and prognostic factors.

Main Results:

  • Acute arterial ischemic insults present differently in neonates (seizures) versus children (hemiparesis).
  • Risk factors include thromboembolic events in neonates and vasculopathies/cardiac issues in children.
  • Magnetic Resonance Imaging (MRI) is the gold standard for diagnosis; treatment lacks strong evidence, with platelet aggregation suggested.
  • Spinal artery ischemia and sinus venous thromboses are other significant pediatric cerebrovascular events with distinct presentations and prognoses.
  • Two-thirds of affected children experience lifelong neurological and neuropsychological challenges.

Conclusions:

  • Pediatric cerebrovascular diseases encompass arterial ischemic strokes, spinal artery ischemia, and sinus venous thromboses.
  • Early diagnosis via MRI and consideration of platelet aggregation or anticoagulation are key.
  • Long-term deficits are common, emphasizing the need for improved therapeutic strategies and preventative measures.

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