Archives of Disease in Childhood 2008;93:890-898
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Cerebrovascular disease and stroke
1 Departments of Paediatric Intensive Care and Paediatric Neurology, Child Health Directorate, Southampton General Hospital, Southampton, UK
2 Institute of Child Health, London, UK
Professor Fenella Kirkham, The Wolfson Centre, Mecklenburgh Square, London WC1N 2AP, UK; F.Kirkham{at}ich.ucl.ac.uk
Stroke and cerebrovascular disorders are important causes of morbidity and mortality in children; they are already amongst the top 10 causes of childhood death and are probably increasing in prevalence. Acute treatment of stroke syndromes in adults is now evidence based. However, paediatric stroke syndromes are far less common and the differential diagnosis is very wide, but the individual health resource implications are much greater because of the life-long treatment costs in survivors. Recognition and consultation with a paediatric neurologist should be rapid so that children can benefit from regional services with emergency neurological, neuroradiological and neurosurgical intervention and paediatric intensive care. This review focuses on the epidemiology, presentation, differential diagnosis, generic/specific emergency management and prognosis of acute stroke in children. Its aim is to educate and guide management by general paediatricians and to emphasise the importance of local guidelines for the initial investigation and treatment and appropriate transfer of these children.
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