Arterial ischemic stroke in non-neonate children: Diagnostic and therapeutic specificities - 18/02/20

Doi : 10.1016/j.neurol.2019.03.005

M. Kossorotoff ^a,^b,^⁎ , S. Chabrier ^a,^c,^d, K. Tran Dong ^a, S. Nguyen The Tich ^a,^e, M. Dinomais ^a,^f
^a French Center for Pediatric Stroke, France
^b Pediatric neurology, AP–HP, university hospital Necker–Enfants-malades, INSERM U894, 75015 Paris, France
^c INSERM, Lyon university, U1059 Sainbiose, 42000 Saint-Étienne, France
^d CHU de Saint-Étienne, service de médecine physique et de réadaptation pédiatrique, INSERM CIC1408, 42000 Saint-Étienne, France
^e Pediatric neurology, CHU de Lille, 59000 Lille, France
^f CHU d’Angers, department of physical and rehabilitation medicine, university of Angers, 49000 Angers, France

^⁎Corresponding author at: Centre national de référence de l’AVC de l’enfant, service de neuropédiatrie, hôpital universitaire Necker–Enfants-maladies, 149, rue de Sèvres, 75015 Paris, France.Centre national de référence de l’AVC de l’enfant, service de neuropédiatrie, hôpital universitaire Necker–Enfants-maladies149, rue de SèvresParis75015France

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Abstract

Pediatric arterial ischemic stroke (AIS) is a severe condition, with long-lasting devastating consequences on motor and cognitive abilities, academic and social inclusion, and global life projects. Awareness about initial symptoms, implementation of pediatric stroke code protocols using MRI first and only and adapted management in the acute phase, individually tailored recanalization treatment strategies, and multidisciplinary rehabilitation programs with specific goal-centered actions are the key elements to improve pediatric AIS management and outcomes. The main cause of pediatric AIS is focal cerebral arteriopathy, a condition with unilateral focal stenosis and time-limited course requiring specific management. Sickle cell disease and moyamoya angiopathy patients need adapted screening and therapeutics.

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Keywords : Stroke, Children, Thrombolysis, Stroke code, Focal cerebral arteriopathy, Rehabilitation

Abbreviations : AIS, ASL, ASPECTS, FAST scale, FCA, ICF, ICU, IV, MDT, MMA, mRS, PedNIHSS, PSOM, WISC