Treatment of arterial ischemic stroke in children.

Children's National Medical Center, Department of Neurology, Washington, DC 20010, USA.
Expert Review of Neurotherapeutics (Impact Factor: 2.83). 04/2007; 7(4):383-92. DOI: 10.1586/14737175.7.4.383
Source: PubMed

ABSTRACT Stroke is a rare but increasingly recognized disorder in children. Current therapies for arterial ischemic stroke include thrombolytic, antithrombotic and antiplatelet agents, blood transfusion and surgery. Adult studies, pediatric case studies and expert opinion form the basis for these treatment strategies. Thrombolytic agents are increasingly used but, as in adults, the majority of arterial ischemic strokes in children are treated with antiplatelet and antithrombotic agents. Sickle-cell patients, a distinct subset of the pediatric stroke population, are treated primarily with transfusion therapy. Pediatric arterial ischemic stroke studies are needed to determine the most appropriate course of treatment. An international study is currently in progress to formally study the incidence, risk factors, treatment strategies and outcomes of stroke in children.

  • Source
    Advances in Pediatrics 01/2009; 56:271-99. DOI:10.1016/j.yapd.2009.08.003
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Acute ischemic stroke in a pediatric patient is a complex disease with a variety of etiologies that differ from adults. Though rare, they are a real phenomenon with potentially devastating consequences. Some treating institutions are using anti-thrombotic drug therapy with unclear benefits. Available literature, which is limited to case reports and retrospective reviews of databases, clouds this topic with both positive and negative outcomes. Emergency department management should focus on stabilization and resuscitation with immediate involvement of a pediatric neurologist and intensivist. The decision to use anti-thrombotic drug therapy, including anti-platelet drugs and thrombolytics, should be in consult with the specialists involved until randomized controlled trials determine their safety and efficacy in the pediatric population.
    The western journal of emergency medicine 12/2008; 9(4):225-7.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Stroke is an important cause of childhood mortality and morbidity. The risk factors and pathophysiological processes of stroke in children are very different than those in adults. The range of risk factors is very wide, with over 100 presumptive risk factors described. There are a number of clinical guidelines, but despite recent increases in research, the evidence base underpinning these guidelines is sparse. Therefore, treatment is largely based upon expert consensus and extrapolation from adult data. Mortality from childhood stroke is relatively high and at least two-thirds of survivors have neurological impairments. Stroke can affect a wide range of neurocognitive domains and a high proportion of children require additional educational support and have a reduced quality of life.
    Expert Review of Neurotherapeutics 08/2010; 10(8):1331-46. DOI:10.1586/ern.10.106 · 2.83 Impact Factor