Stroke in children with congenital or acquired heart disease

Area of Science:

• Pediatric Cardiology
• Neurology
• Vascular Medicine

Background:

• Children with congenital or acquired cardiac disease exhibit heightened vulnerability to both ischemic and hemorrhagic stroke.
• This review synthesizes current knowledge on stroke in this pediatric population.

Purpose of the Study:

• To review the epidemiology, clinical presentation, acute management strategies, and outcomes of stroke in children with heart disease.
• To highlight recent advancements and ongoing challenges in stroke care for pediatric patients with cardiac conditions.

Main Methods:

• Literature review of epidemiological data, clinical case studies, and registry findings.
• Analysis of recent advancements in interventional procedures, specifically endovascular thrombectomy.
• Synthesis of evidence regarding stroke prevention and long-term outcomes.

Main Results:

• Endovascular thrombectomy for large vessel occlusions (LVOs) shows promise for children with cardioembolic stroke, often presenting with LVO.
• Registry studies suggest thrombectomy may improve outcomes for pediatric LVO stroke, including those with congenital or acquired heart disease.
• Primary and secondary stroke prevention remain critical yet challenging, with long-term risks of stroke, frailty, and cognitive impairment persisting in adults with congenital heart disease.

Conclusions:

• Children with cardiac disease face a persistent, lifelong elevated risk of stroke.
• Interventions like thrombectomy may enhance acute outcomes, but long-term neurological recovery requires further investigation and improved therapeutic strategies.