Cerebrovascular disease was selected as the topic for the 10th Neurobiology of Disease in Children Symposium, which was held October 13, 2010, in Providence, Rhode Island. Program directors Drs Gabrielle deVeber, Donna Ferriero, Steve Roach, and Zinaida Vexler prepared an outstanding agenda with individual presentations by and a panel discussion with highly respected leaders in the field of cerebrovascular disease. The conference covered the clinical aspects, pathogenesis, and current management of various forms of childhood stroke, followed by a session on controversial topics and unanswered questions, and concluded with a panel discussion consisting of many of the day’s speakers. Dr deVeber opened the symposium with a talk highlighting recent insights in diagnosis and initial treatment of pediatric stroke. One of the main forms of childhood stroke, arterial ischemic stroke, was introduced by Dr Adam Kirton, who emphasized the importance of using imaging to more efficiently diagnose children with stroke. Dr Kirton made the point—echoed by many speakers throughout the day—that childhood stroke is far more common than has previously been thought. Dr Heather Fullerton continued the discussion of arterial ischemic stroke, focusing on common symptoms of stroke and how to recognize them as well as basic management. Dr Fullerton gave a second presentation later in the day that covered secondary stroke prevention in children, covering not only the role of antithrombotics but other treatment options for secondary stroke prevention. Cerebral sinovenous thrombosis was covered by both Dr Linda DeVries and Dr Fenella Kirkham. Dr DeVries focused on the importance of imaging for diagnosis of perinatal cerebral sinovenous thrombosis and statistical data from the International Pediatric Stroke Study. Dr Kirkham’s talk centered on childhood cerebral sinovenous thrombosis, presenting the interesting finding that iron deficiency is common in children with this condition. In an afternoon session, Dr Mahendra Moharir spoke on the clinical management and challenges of treating neonatal sinovenous thrombosis and addressed the debate regarding the use of anticoagulant therapy as treatment. The third and final form of childhood stroke, hemorrhagic stroke, was covered by Dr Warren Lo, who focused specifically on intracranial and subarachnoid hemorrhage. Dr Lo presented a broad view of hemorrhagic stroke, including incidence, identified risk factors, diagnosis, and management, touching on the American Heart Association guidelines that were presented in detail during a later session. A session on the pathogenesis of childhood stroke provided valuable insight into several topics. Dr Frank Sharp presented data on gene expression profiling of blood cells in ischemic stroke and introduced several gene profiles that have been useful in diagnosing stroke, particularly when the cause of ischemia is unknown. Dr Eng Lo covered the topic of neurovascular niche, positing the entire neurovascular unit as a target for therapy and highlighting recent investigations into neuroprotection, including the cerebral endothelium as a neuroprotective organ. The role of inflammation in stroke was presented by Dr Zinaida Vexler, who discussed not only the detrimental effects of inflammation in the poststroke cellular environment but also its contribution to recovery neurogenesis and investigations into how to enhance this effect. Dr Patricia Massicotte presented on thrombus formation, the inciting event of arterial ischemic stroke, highlighting the differences in thrombus formation in children from that in adults, particularly that vitamin K–dependent factors are decreased in children, as are thrombin, protein C, and protein S, although plasminogen activator inhibitor levels are increased. Finally, Dr Michael Rivkin shared insights into nervous system plasticity based on new developments in neuroimaging, particularly into cortical synaptogenesis and pruning. In a session on management and therapy, Dr Steve Roach shared the latest American Heart and Stroke Association Guidelines on diagnosis and management of childhood stroke.
Search from 250 M+ research papersSearch from 250 M+ research papers
Apr 15, 2013
Jorina Elbers + 3
Open Access