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Neuroimaging of Pediatric Intracerebral Hemorrhage
Peter B Sporns1,2, Marios-Nikos Psychogios1, Heather J Fullerton3
1Department of Neuroradiology, Clinic for Radiology & Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.
Insights
Pediatric hemorrhagic strokes, often caused by vascular issues, require tailored neuroimaging. Magnetic resonance imaging (MRI) is preferred for acute intracerebral hemorrhage diagnosis in children.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Pediatric Stroke
Background:
- Hemorrhagic strokes constitute 50% of childhood strokes, with distinct etiologies from adults.
- Intracerebral hemorrhage (ICH) in children presents unique diagnostic challenges.
- Understanding specific pediatric stroke causes is crucial for effective management.
Purpose of the Study:
- To review the incidence, etiologies, and presentation of pediatric intracerebral hemorrhage.
- To guide neuroimaging strategies for diagnosing ICH in children.
- To recommend optimized imaging protocols for acute and follow-up evaluations.
Main Methods:
- Literature review focusing on pediatric intracerebral hemorrhage.
- Analysis of diagnostic approaches and neuroimaging techniques.
- Emphasis on tailored imaging protocols based on clinical context.
Main Results:
- Pediatric ICH etiologies differ significantly from adult populations.
- Vascular lesions are highly prevalent and require specific imaging.
- Magnetic resonance imaging (MRI) with advanced sequences is recommended for acute diagnosis.
Conclusions:
- Neuroimaging protocols for pediatric ICH must be individualized.
- Vascular imaging is essential for identifying underlying causes.
- Timely and appropriate MRI can improve diagnostic accuracy in acute pediatric stroke.
Abstract:
Hemorrhagic strokes account for half of all strokes seen in children, and the etiologies of these hemorrhagic strokes differ greatly from those seen in adult patients. This review gives an overview about incidence and etiologies as well as presentation of children with intracerebral hemorrhage and with differential diagnoses in the emergency department. Most importantly it describes how neuroimaging of children with intracerebral hemorrhage should be tailored to specific situations and clinical contexts and recommends specific imaging protocols for acute and repeat imaging. In this context it is important to keep in mind the high prevalence of underlying vascular lesions and adapt the imaging protocol accordingly, meaning that vascular imaging plays a key role regardless of modality. Magnetic resonance imaging (MRI), including advanced sequences, should be favored whenever possible at the acute phase.
