Presentation
Hemi-anopsia was the presenting symptom in 4 (57%) of the 7 patients with occipital stroke. Table 2. [ahajournals.org]
Several predictors of the delayed AIS diagnosis were identified in the present study. Efforts to target these predictors can reduce diagnostic delays and optimize the management of AIS in children. [ncbi.nlm.nih.gov]
No identifiable RFs was present in 54 (9%). [onlinelibrary.wiley.com]
Most of the patients presented with motor involvement (79%) and seizures (45%). Patients presented less frequently with consciousness impairment (15%) and headache (10%). [journals.sagepub.com]
Entire Body System
- Varicella-Zoster Virus Infection
varicella-zoster virus infection with approximately 14% of children with a a prothrombotic condition and 86% previously healthy. focal cerebral anteriopathy Idiopathic arterial stenosis occurring in the brain providing an inciting region for occlusion [hawaii.edu]
Furthermore, although the varicella vaccine has markedly reduced the incidence of varicella infection, children 5 to 9 years of age continue to have the highest incidence. 39 In the absence of specific virological testing, varicella zoster virus may go [ahajournals.org]
The results of this case-control study show a significant statistical link between idiopathic arterial ischemic strokes in children and varicella-zoster virus infection. [researchgate.net]
- Plethora
The uncommon incidence, age-associated difference and plethora of clinical symptoms make the diagnosis of such strokes extremely difficult and often delayed. The history and clinical examination should point to diseases or predisposing factors. [biomed.papers.upol.cz]
Neurologic
- Grunting
61 Slavova N...Grunt S 30722076 2019 6 Hemorrhagic Transformation of Arterial Ischemic and Venous Stroke in Children. 61 Hutchinson ML...Beslow LA 30904397 2019 7 Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric [malacards.org]
Grunt S, Mazenauer L, Buerki SE, Boltshauser E, Mori AC, Datta AN, et al. Incidence and Outcomes of Symptomatic Neonatal Arterial Ischemic Stroke. Pediatrics [Internet]. 2015;135(5):e1220–8. [journals.plos.org]
Grunt S, Wingeier K, Wehrli E, Boltshauser E, Capone A, Fluss J et al. Cerebral sinus venous thrombosis in Swiss children. Dev Med Child Neurol 2010; 52; 12: 1145–50. Guideline development group, Royal College of Paediatrics and Child Health (2017). [signavitae.com]
One neuroradiologist (Dr Slavova) and 3 neuropediatricians (Drs Bigi, Steinlin, and Grunt), blinded to the clinical information, reviewed the imaging studies to identify the area of ischemia and the affected vessels. [ahajournals.org]
(Prospective cohort study; 355 children) Grunt S, Mazenauer L, Buerki SE, et al. Incidence and outcomes of symptomatic neonatal arterial ischemic stroke. Pediatrics. 2015;135(5):e1220-e1228. [ebmedicine.net]
Workup
Volpe warned that as soon as the case seems to be progressing, involves pain, or is associated with atypical disc findings, a more detailed workup is indicated, including an MRI scan and blood workup for systemic inflammation and multiple sclerosis. [aao.org]
After transfer to a children’s hospital and an exhaustive workup, the etiology of his stroke remained unclear. At four-month outpatient follow-up, the patient had only minimal left arm weakness. [westjem.com]
[…] amputation or explanation needed Limb Ataxia 0-2: absent to present in 2 limbs Sensory 0-2: normal to severe/total sensory loss Best Language 0-3: no aphasia to mute/global aphasia Labs and Imaging Imaging is of critical importance in the diagnostic workup [hawaii.edu]
MR imaging is not routinely performed as part of the workup of patients with these neoplasms because of their typical clinical appearance and superficial location. [ajronline.org]
Cardiac workup of ischemic stroke: can we improve our diagnostic yield?Stroke. 2009; 40:2893–2898. doi: 10.1161/STROKEAHA.109.551226LinkGoogle Scholar 28. [ahajournals.org]
Saliva
- Excessive Drooling
His main problem became his poor articulation and excessive drooling but he did not appear to have major cognitive difficulties. [mrineonatalbrain.com]
Other ECG Findings
- Ischemic Changes
This can be avoided by rapid transportation of such patients to a neurocenter and rapid evacuation before occurrence of ischemic changes. 1. Mirvis SE, Wolf AL, Numaguchi Y, Corradino G, Joslyn JN. [pediatricneurosciences.com]
Cerebral venous sinus thrombosis occurs more often in the superficial venous system than within the deep veins. 1 On a cellular level, ischemic changes precipitate a series of events that result in tissue necrosis. [now.aapmr.org]
changes in pediatric PCAIS based on the knowledge of vascular territories of the posterior circulation,6,23,30 in combination with symptoms at presentation. [ahajournals.org]
Therefore, it is important to study cerebral, post-ischemic changes in detail. [journals.plos.org]
Treatment
In their cohort, at most, four children per year underwent recanalization treatment. [reliasmedia.com]
61 Slavova N...Grunt S 30722076 2019 6 Hemorrhagic Transformation of Arterial Ischemic and Venous Stroke in Children. 61 Hutchinson ML...Beslow LA 30904397 2019 7 Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric [malacards.org]
Definitive evidence-based treatment for pediatric stroke awaits the development of randomized controlled trials. [ncbi.nlm.nih.gov]
Bernaud T J; Treatment of Childhood Arterial Ischemic stroke; Ann Neurol 2008;63:679â696 16. [bestbets.org]
Prognosis
Prognosis The prognosis is excellent for low grade lesions but a poorer prognosis is associated with the FS variant due to a higher risk of recurrence and metastases. Overall, the rate of mortality is low (< 3% at 10 years). [orpha.net]
MRI T1: low signal T2 high signal usually higher than or equal to adjacent subcutaneous fat fat saturation sequences: suppressed T1 C+ (Gd): enhances Treatment and prognosis Dermatofibrosarcoma protuberans has an excellent prognosis after complete resection [radiopaedia.org]
Natural history, prognosis and lipid abnormalities of idiopathic ischemic childhood stroke. J Child Neurol. 1996; 11:276-282 Hemorrhagic stroke have higher mortality rates as compared to ischemic stroke. [slideshare.net]
The general prognosis for DFSP is excellent. [sarcomahelp.org]
prognosis as excellent; DFSP are also reported to have a high recurrence rate. [ncbi.nlm.nih.gov]
Etiology
This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke (PAIS). [ncbi.nlm.nih.gov]
ETIOLOGIES/RISK FACTORS Etiologies/risk factors in childhood stroke differ from those in adult stroke 11). [jkns.or.kr]
This review examines the epidemiology and etiologies of neonatal and childhood AIS and provides a detailed discussion of approaches to the clinical… CONTINUE READING [pdfs.semanticscholar.org]
In childhood AIS, the reported frequency of potential etiologies and risk factors vary considerably depending upon the population studied and extent of etiological investigations. [jpma.org.pk]
Epidemiology
Pediatric arterial ischemic stroke: Epidemiology, risk factors, and management. [jhu.pure.elsevier.com]
This review examines the epidemiology and etiologies of neonatal and childhood AIS and provides a detailed discussion of approaches to the clinical characterization, diagnostic evaluation, and management. [ncbi.nlm.nih.gov]
This review examines the epidemiology and etiologies of neonatal and childhood AIS and provides a detailed discussion of approaches to the clinical… CONTINUE READING [pdfs.semanticscholar.org]
Pathophysiology
It is unclear if inflammation is an aspect of the pathophysiology of stroke, or a consequence of tissue injury. [ 1 ] COMMENTARY. [pediatricneurologybriefs.com]
After an opening section on basics such as pathophysiology, radiological assessment, and pathology, comprehensive and up-to-date information is provided on each of the available therapies, techniques, and practices. [books.google.com]
"Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms." NeuroRehabilitation 26 (1): 5-13. Calvert, J. W. and J. H. Zhang (2005). "Pathophysiology of an hypoxic-ischemic insult during the perinatal period." [internationalbrain.org]
Additional complicating factors include typically increased delays and increased challenge to appropriate diagnosis in children relative to adults, and underlying differences in the pathophysiology of AIS, the thrombotic cascade, and the natural history [content.iospress.com]
This article reviews the unique pathophysiologic entities affecting the pediatric population and the associated MRI findings. [researchgate.net]
Prevention
“With the consequences of childhood stroke so often devastating and lifelong, it is critical to find out as much as we can about it and develop strategies to prevent it, recognize it when it occurs and prevent further recurrence,” says Dr. Friedman. [consultqd.clevelandclinic.org]
The results of the current study could be used for planning more preventive strategies in patients suffering from the mentioned diseases. [ijpvmjournal.net]
Acute treatment of AIS in children is aimed to arrest extension of occlusive thrombosis and prevent early recurrence of stroke. Further management is directed towards prevention of longer-term stroke recurrence. [bestbets.org]
RECENT FINDINGS: Arterial ischemic stroke in children represents a significant disorder with a concerning high rate of adverse outcomes, including potentially preventable recurrent stroke. [ncbi.nlm.nih.gov]
Arterial ischemic stroke in children represents a significant disorder with a concerning high rate of adverse outcomes, including potentially preventable recurrent stroke. [journals.lww.com]