Pathways for Neuroimaging of Childhood Stroke

Publication date: Available online 25 January 2017
Source:Pediatric Neurology
Author(s): D.M. Mirsky, L.A. Beslow, C. Amlie-Lefond, P. Krishnan, S. Laughlin, S. Lee, L. Lehman, M. Rafay, D. Shaw, Rivkin M, M. Wintermark
PurposeThe purpose of this paper is to aid practitioners in choosing appropriate neuroimaging for children who present with symptoms that could be caused by stroke.MethodsThe Writing Group members participated in one or more pediatric stroke neuroimaging symposiums hosted by the Stroke Imaging Laboratory for Children (SILC) housed at The Hospital for Sick Children in Toronto, Ontario, Canada. Through collaboration, literature review, and discussion among child neurologists with expertise diagnosing and treating childhood stroke and pediatric neuroradiologists and neuroradiolgists with expertise in pediatric neurovascular disease, suggested imaging and imaging protocols are presented for children with suspected stroke syndromes including arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke.ResultsThe manuscript presents sections on epidemiology and classification of childhood stroke with definitions based on the National Institutes of Health Common Data Elements. The role of imaging for the diagnosis of childhood stroke is examined in depth, with separate sections for arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke. Abbreviated neuroimaging protocols for rapid diagnosis are discussed. The Writing Group provides suggestions for optimal neuroimaging investigation of various stroke types in the acute setting as well as suggestions for follow-up neuroimaging. Advanced sequences like diffusion tensor imaging, perfusion imaging, and vessel wall imaging are also discussed.



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