Childhood Stroke

Posted by e-Medical PPT
The cause of stroke in children is unknown in one-third of cases.  The most common reported risk factors for stroke in children include cardiac disorders, sickle cell disease, coagulation disorders, arterial dissection, moya moya, infection, and other rare genetic disorders.Cardiac disorders  are the most common cause of ischemic stroke in children and account for up to 50% of strokes in case series. The risk of stroke in children with congenital heart disease is related to the abnormality, diagnostic and surgical procedures, and associated genetic or acquired factors that predispose children to thrombosis. Cardiac disorders can lead to the development of intracardiac thrombi that may embolize to the brain or can lead to thrombosis in cyanotic patients with anemia.
Blood disorders  are the second most common cause of stroke in children.  Several blood disorders associated with stroke in children include:
    *Sickle cell disease is the most common cause of stroke in African American children. The recurrence risk for this group is very high.
    *Coagulation disorders can lead to a tendency to clot or hemorrhage.  The risk of stroke seems to be greatest among children who have a combination of genetic factors. Multiple factors are associated with a heightened risk of thrombosis and recurrence.
Vascular Disorders -  23% of children with arterial ischemic stroke in one study
    *Moya-Moya disease is a chronic non-inflammatory occlusive intracranial vasculopathy of unknown cause. 
    *Arterial dissection, a common cause of stroke in children, is usually due to trauma.

Causes of Hemorrhagic Stroke in a child
Vascular malformations, blood disorders and malignancy  have been identified as risk factors in children who have a hemorrhagic stroke.
    *Vascular malformations, including arteriovenous malformations (AVMs), aneurysms, and cavernous malformations are the most common risk factors for children with hemorrhagic stroke.
    *Blood disorders, including thrombocytopenia, leukemia, SCD, and coagulopathies have been identified in some children with hemorrhagic stroke.  Acquired thrombocytopenia and coagulopathies were the most common blood risk factors in one report.
    *Intracranial tumors, including medulloblastomas and primitive neuroectodermal tumors, have been identified in cases of children who have a hemorrhagic stroke.

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