Recent advances in childhood arterial ischemic stroke

Abstract

Although many underlying diseases have been reported in the setting of childhood arterial ischemic stroke, emerging research demonstrates that non-atherosclerotic intracerebral arteriopathies in otherwise healthy children are prevalent. Minor infections may play a role in arteriopathies that have no other apparent underlying cause. Although stroke in childhood differs in many aspects from adult stroke, few systematic studies specific to pediatrics are available to inform stroke management. Treatment trials of pediatric stroke are required to determine the best strategies for acute treatment and secondary stroke prevention. The high cost of pediatric stroke to children, families, and society demands further study of its risk factors, management, and outcomes. This review focuses on the recent findings in childhood arterial ischemic stroke.

Fig. 1

A magnetic resonance angiography (MRA) image taken 7 months after a stroke in a 7-year-old girl demonstrates a persistent, stable, unilateral stenosis of the left proximal middle cerebral artery. This imaging is typical of “transient cerebral arteriopathy,” a monophasic focal cerebral arteriopathy observed in many previously healthy children with stroke. The stenosis shown in this image (arrow) was essentially unchanged from the MRA done acutely after the stroke