Cerebrovascular occlusive disease in childhood

It is clear that for many disorders involving the CNS in children, cerebrovascular occlusion with stroke or strokelike episodes may be an important part of their pathophysiology. In contrast to adults, no single entity is responsible for the majority of strokes in children. The incidence of childhood cerebrovascular occlusive disease is likely much higher than is recorded in the literature if one takes into account conditions in which vascular occlusion plays a significant but secondary role. In some disorders, the occlusive process is often produced by the therapy used to treat the underlying primary disorder (e.g., radiation injury) and often accounts for the greatest morbidity and mortality to the patient. Imaging plays an important role in the detection and follow-up of cerebrovascular occlusive disease in children. A better understanding by the radiologist of the full range of conditions that may be complicated by stroke is important if we are to play a role in early diagnosis and to help guide specific therapy aimed at preventing a recurrence of the event. Imaging has become complex; however, a combination of anatomic and functional imaging is essential in the appropriate workup and management of all children with cerebrovascular occlusive disease.