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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Brainstem strokes in children: an 11-year series from a tertiary pediatric center

Nancy Rollins1, Glen Lee Pride, Patricia A Plumb

  • 1Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.

Pediatric Neurology
|October 2, 2013
PubMed

Insights

Timely diagnosis of pediatric brainstem stroke is challenging due to vague symptoms. Prompt anticoagulation improves outcomes, and magnetic resonance angiography is effective for basilar artery occlusion.

Area of Science:

  • Pediatric Neurology
  • Vascular Imaging
  • Stroke Medicine

Background:

  • Pediatric brainstem stroke diagnosis can be delayed by nonspecific symptoms.
  • Accurate and timely vascular imaging is crucial for effective treatment.

Purpose of the Study:

  • To identify clinical barriers and imaging pitfalls in diagnosing pediatric brainstem stroke.
  • To compare the efficacy of magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) in pediatric brainstem stroke.

Main Methods:

  • Retrospective review of 15 pediatric brainstem stroke cases (2001-2012).
  • Analysis of patient symptoms, stroke severity (Pediatric National Institutes of Health Stroke Scale), and outcomes (Pediatric Stroke Outcome Measure).
  • Comparison of MRA findings with DSA in evaluating basilar artery and vertebral artery pathologies.

Main Results:

  • Common symptoms included headaches, visual problems, and motor deficits.
  • MRA accurately detected basilar artery occlusion in 8/13 patients.
  • DSA confirmed MRA findings for basilar artery occlusion but identified more cases of vertebral artery dissection.

Conclusions:

  • Nonspecific symptoms often lead to diagnostic delays in pediatric brainstem stroke.
  • MRA is comparable to DSA for basilar artery occlusion but less sensitive for vertebral artery dissection.
  • Prompt systemic anticoagulation is associated with favorable outcomes despite severe strokes.
Abstract

Keywords:
arterial dissectionbrainstem strokedigital subtraction angiographymagnetic resonance angiography (MRA)outcomepediatric

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