Arteriopathy in pediatric stroke: an underestimated clinical entity / Arteriopatia em crianças com acidente vascular cerebral: uma entidade clínica subestimada
Pizzatto, Ronaldo; Resende, Lucas Lopes; Lobo, Carlos Felipe Teixeira; Neves, Yuri Costa Sarno; Paz, José Albino da; Alves, César Augusto Pinheiro Ferreira; Leite, Claudia da Costa; Lucato, Leandro Tavares.
Arq. neuropsiquiatr
; 79(4): 321-333, Apr. 2021. tab, graf
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en Inglés
| LILACS | ID: biblio-1278384
ABSTRACT
Background:
Pediatric arterial ischemic stroke (AIS), which was thought to be a rare disorder, is being increasingly recognized as an important cause of neurological morbidity, thanks to new advances in neuroimaging.Objective:
The aim of this study was to review the main etiologies of stroke due to arteriopathy in children.Methods:
Using a series of cases from our institution, we addressed its epidemiological aspects, physiopathology, imaging findings from CT, MR angiography, MR conventional sequences and MR DWI, and nuclear medicine findings.Results:
Through discussion of the most recent classification for childhood AIS (Childhood AIS Standardized Classification and Diagnostic Evaluation, CASCADE), we propose a modified classification based on the anatomical site of disease, which includes vasculitis, varicella, arterial dissection, moyamoya, fibromuscular dysplasia, Takayasu's arteritis and genetic causes (such as ACTA-2 mutation, PHACE syndrome and ADA-2 deficiency). We have detailed each of these separately.Conclusions:
Prompt recognition of AIS and thorough investigation for potential risk factors are crucial for a better outcome. In this scenario, neurovascular imaging plays an important role in diagnosing AIS and identifying children at high risk of recurrent stroke.
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