Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct:43:100992.
doi: 10.1016/j.spen.2022.100992. Epub 2022 Aug 31.

Pediatric Stroke and Cardiac Disease: Challenges in Recognition and Management

Elizabeth W Mayne  1 , Janette A Mailo  2 , Lisa Pabst  3 , Elizabeth Pulcine  4 , Dana B Harrar  5 , Michaela Waak  6 , Mubeen F Rafay  7 , Sahar Ma Hassanein  8 , Catherine Amlie-Lefond  9 , Lori C Jordan  10
Affiliations

Pediatric Stroke and Cardiac Disease: Challenges in Recognition and Management

Elizabeth W Mayne et al. Semin Pediatr Neurol. 2022 Oct.
No abstract available

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.. Imaging Patterns in children with cardiac stroke.
(A) CT scan demonstrating hypoattenuation consistent with acute R MCA infarct. (B) MR Angiogram demonstrating acute occlusion of the right M1 artery. (C) MRI demonstrating multifocal areas of restricted diffusion concerning for embolic process. (D) restricted diffusion in the bilateral posterior watershed regions and right anterior watershed region. Images showing (E) restricted diffusion consistent with acute R MCA infarction and (F) susceptibility-weighted imaging demonstrating hemorrhagic transformation from the same patient as panel E.
Figure 2.
Figure 2.. Initial Diagnostic Steps in acute stroke.
Many cardiac patients have implanted devices that are MRI incompatible (pacemakers, implantable cardiac defibrillators (ICDs), post-operative pacing wires, sternal wires, ventricular assist devices (VADs), chest tubes). DWI- diffusion weighted imaging, ADC- apparent diffusion coefficient, FLAIR- fluid attenuated inversion recovery, SWI- susceptibility weighted imaging, LKW- last known well, ACT- activated clotting time, LVO- large vessel occlusion
Figure 3.
Figure 3.
Initial Management of Intracranial Hemorrhage in Children with Cardiac Disease
See this image and copyright information in PMC

References

    1. Dowling MM et al. International Paediatric Stroke Study: stroke associated with cardiac disorders. Int. J. Stroke 8 Suppl A100, 39–44 (2013). - PMC - PubMed
    1. Giang KW et al. Long-Term Risk of Hemorrhagic Stroke in Young Patients With Congenital Heart Disease. Stroke 49, 1155–1162 (2018). - PMC - PubMed
    1. Licht DJ et al. Brain maturation is delayed in infants with complex congenital heart defects. J. Thorac. Cardiovasc. Surg. 137, 529–36; discussion 536–7 (2009). - PMC - PubMed
    1. Miller SP et al. Abnormal brain development in newborns with congenital heart disease. N. Engl. J. Med. 357, 1928–1938 (2007). - PubMed
    1. Fogel MA et al. Neurological Injury and Cerebral Blood Flow in Single Ventricles Throughout Staged Surgical Reconstruction. Circulation vol. 135 671–682 Preprint at 10.1161/circulationaha.116.021724(2017). - DOI - PMC - PubMed

Publication types