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Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Childhood stroke
Peter B Sporns1,2, Heather J Fullerton3, Sarah Lee4
1Department of Neuroradiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Insights
Childhood stroke, distinct from perinatal stroke, presents unique challenges in diagnosis and treatment. Advances in pediatric stroke research are ongoing, but evidence for interventions remains limited, necessitating global collaboration for improved outcomes.
Area of Science:
- Neurology
- Pediatrics
- Cerebrovascular Disease
Background:
- Childhood stroke causes significant long-term neurological deficits.
- Pediatric stroke differs from perinatal stroke due to unique maternal-fetal pathogenesis.
- Childhood strokes are equally divided between hemorrhagic and ischemic types, unlike adult strokes.
Purpose of the Study:
- To provide a comprehensive overview of childhood stroke.
- To highlight the unique aspects of pediatric stroke pathogenesis and causes.
- To discuss diagnostic and therapeutic challenges and future directions in pediatric cerebrovascular disease.
Main Methods:
- Review of current literature and research in pediatric stroke.
- Emphasis on diagnostic imaging and hyperacute therapies.
- Discussion of secondary stroke prevention strategies based on etiology.
Main Results:
- Childhood stroke has distinct causes and a higher proportion of hemorrhagic strokes compared to adults.
- Urgent brain imaging is critical for diagnosis and guiding acute treatments.
- Evidence quality for interventions in pediatric stroke is generally low, despite advances.
Conclusions:
- Substantial delays in diagnosis and treatment persist, impacting patient care.
- Effective primary prevention exists for sickle cell disease but faces implementation barriers.
- Global collaboration is essential to address challenges and improve outcomes in pediatric cerebrovascular disease.
Abstract:
Stroke is an important cause of neurological morbidity in children; most survivors have permanent neurological deficits that affect the remainder of their life. Stroke in childhood, the focus of this Primer, is distinguished from perinatal stroke, defined as stroke before 29 days of age, because of its unique pathogenesis reflecting the maternal-fetal unit. Although approximately 15% of strokes in adults are haemorrhagic, half of incident strokes in children are haemorrhagic and half are ischaemic. The causes of childhood stroke are distinct from those in adults. Urgent brain imaging is essential to confirm the stroke diagnosis and guide decisions about hyperacute therapies. Secondary stroke prevention strongly depends on the underlying aetiology. While the past decade has seen substantial advances in paediatric stroke research, the quality of evidence for interventions, such as the rapid reperfusion therapies that have revolutionized arterial ischaemic stroke care in adults, remains low. Substantial time delays in diagnosis and treatment continue to challenge best possible care. Effective primary stroke prevention strategies in children with sickle cell disease represent a major success, yet barriers to implementation persist. The multidisciplinary members of the International Pediatric Stroke Organization are coordinating global efforts to tackle these challenges and improve the outcomes in children with cerebrovascular disease.
