Pediatric Cerebrovascular Disorders Research Articles

Cerebral Digital Subtraction Angiography in Acute Intracranial Hemorrhage: Considerations in Critically Ill Children

Cerebrovascular disorders are an important cause of morbidity and mortality in children. Although minimally invasive, cerebral digital subtraction angiography (DSA) has been shown to be safe in children and is a valuable, and perhaps underutilized, technique for the diagnosis and management of pediatric cerebrovascular disorders in the critical care setting. Through a case-based approach, we explore the utility of DSA in critically ill children with acute intracranial hemorrhage (ICH). We discuss the use of DSA in the acute management of aneurysm and arteriovenous malformation rupture as well as cerebral vasospasm. Those caring for critically ill children with acute ICH should consider cerebral DSA as part of a comprehensive approach to the diagnosis and management of these conditions.

Cerebral Perfusion in Pediatric Stroke: Children Are Not Little Adults.

Cerebral perfusion imaging provides useful information about the hemodynamic state of the brain that is relevant to a number of neurologic conditions, including stroke, epilepsy, and brain tumors. Multiple imaging modalities have been developed to evaluate brain perfusion, primarily by the use of different tracers to measure cerebral blood volume and cerebral blood flow. Here, we provide an overview of magnetic resonance imaging perfusion techniques; summarize the role of perfusion imaging in adult stroke; describe changes in cerebral blood flow over childhood; and discuss the relevance and future directions of perfusion imaging in pediatric cerebrovascular disorders and stroke.

Cerebrovascular disorders in children and adolescents: a report of 204 cases

To investigate the clinical features of pediatric cerebrovascular disorders. The clinical data of 204 cases of pediatric cerebrovascular disease, 134 male and 70 female (1.91: 1), aged 12.7 (32 d - 17.9 years), hospitalized in the past 13 years were analyzed retrospectively. The diagnosis of intracranial hemorrhage was mainly based on CT, Digital subtraction angiography was conducted on 130 cases and pathological examination was conducted on 78 cases. Intracranial hemorrhage was seen in 195 cases. The onset of symptoms was acute or subacute in 73.5% of the patients (150/204). The main manifestations included headache (70.6%), vomiting (50%), loss of consciousness (22.5%), convulsion (21.6%), and focal neurological deficits (13.2%). The causes included arteriovenous malformation (42.2%, 86/204), cavernoma (16.2%, 33/204), aneurysm (8.8%, 18/204), and moyamoya disease (5.9%, 12/204), and the cause remained unknown in 43 of the patients (21%). The epidemiology of pediatric cerebrovascular diseases has its own specificity. Therefore, it is crucial to deal timely with it according to the characteristics of the cerebrovascular diseases in children's.

Pediatric Cerebrovascular Disorders, 2nd Ed

edited by E.S. Roach and Anthony R. Riela, 356 pp., ill., Armonk, NY, Futura Publishing Company, Inc., 1995, $120.00. Few authors have the opportunity, or the inclination, to tackle difficult and important neurologic conditions as the subject of a first text on the subject. Doctors Roach and Riela have done so twice, the first being the initial edition of this book in 1988. In this second edition, chapters have been added that reflect …

Book Review: Pediatric Cerebrovascular Disorders, 2nd ed, by E.S. Roach and Anthony R. Riela. Published in 1995 by Futura Publishing Company, Inc, Armonk, New York, 356 pages, $120.00

Book Review: Pediatric Cerebrovascular Disorders, 2nd ed, by E.S. Roach and Anthony R. Riela. Published in 1995 by Futura Publishing Company, Inc, Armonk, New York, 356 pages, $120.00

Selected indications for and applications of magnetic resonance angiography in children.

The purpose of this study was to investigate the efficacy and practicality of magnetic resonance angiography (MRA) in evaluating pediatric cerebrovascular disorders. A retrospective evaluation was performed of MR angiograms in 20 pediatric patients with cerebrovascular pathology. When appropriate, comparisons were made with duplex ultrasonography or conventional catheter angiography. MRA accurately assessed the patency of carotid reanastomoses in 8 babies who had previously undergone extracorporeal membrane oxygenation (ECMO). In 6 patients with moyamoya syndrome, MRA accurately evaluated stenotic intracranial carotid and circle of Willis arteries and progressive enlargement of the superficial temporal and middle cerebral arteries after revascularization procedures, and thus obviated the need for sequential angiograms. Thrombi and emboli were identified in 4 of 5 patients with symptoms and imaging evidence of an acute stroke. Two-dimensional time-of-flight MR venograms, acquired in both axial and coronal planes, were useful for preoperative venous mapping in a patient with an occipital encephalocele and detecting venoocclusive disease. MRA provided diagnostically useful information in a spectrum of pediatric cerebrovascular disorders. It can be used as the initial vascular imaging modality for patients with imaging evidence of acute cerebrovascular event, to evaluate progression of chronic vasoocclusive disease, to evaluate vessel patency following intracranial revascularization surgery, and for visualization of the venous circulation.

Book Review: Pediatric Cerebrovascular Disorders, by E. S. Roach and Anthony R. Riela. Published in 1988 by Futura Publishing Company, Mount Kisco, New York, 257 pages, $45.00

Book Review: Pediatric Cerebrovascular Disorders, by E. S. Roach and Anthony R. Riela. Published in 1988 by Futura Publishing Company, Mount Kisco, New York, 257 pages, $45.00