Stroke After Cardiac Catheterization in Children

Harrar, Dana; Salussolia, Catherine L.; Vittner, Patrick; Danehy, Amy; Sen, Sonali; Whitehill, Robert; Chao, Jessica; Bernson-Leung, Miya E.; Rivkin, Michael J.

doi:10.1016/j.pediatrneurol.2019.07.005

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…About one-fourth of children with congenital heart disease have a complex form that requires surgical intervention during the first year of life to survive 32 . Many cardioembolic strokes in children are periprocedural and occur in the setting of cardiac surgery or catheterization to manage complex congenital heart disease 33,34 . As surgical management has improved over decades, a larger group of children and young adults with complex congenital heart disease survive early childhood but remain at risk for stroke related to their underlying cardiac dysfunction.…”

Section: Pediatric Stroke Risk Factorsmentioning

confidence: 99%

“…However, stroke diagnosis is frequently delayed even when the stroke occurs in the hospital after cardiac catheterization or surgery. 33,34 Barriers to early diagnosis are common, including sedating or paralytic medications in critically ill children, emergence from anesthesia after a procedure, or difficulty with neurologic examination in poorly cooperative or young children. Systematic quality measures that preemptively identify children for closer postprocedural neurologic monitoring after higher-risk cardiac procedures are key to reducing time to stroke detection and increasing opportunities for rapid treatment.…”

Section: Complex Cardiac Diseasementioning

confidence: 99%

“…Hyperacute reperfusion treatments are a key area of ongoing pediatric stroke research. However, stroke diagnosis is frequently delayed even when the stroke occurs in the hospital after cardiac catheterization or surgery 33,34 . Barriers to early diagnosis are common, including sedating or paralytic medications in critically ill children, emergence from anesthesia after a procedure, or difficulty with neurologic examination in poorly cooperative or young children.…”

Section: Pediatric Stroke Risk Factorsmentioning

confidence: 99%

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Pediatric Ischemic Stroke

Fox¹

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVEPediatric cerebrovascular disease is one of the leading causes of death and disability in children. Survivors of childhood stroke and their families are often left to cope with long-lasting sequelae, such as barriers to school reentry and long-term challenges in attaining independence as adults. Because childhood stroke is rare and providers may not be familiar with the disorder, this article reviews the risk factors, acute management, and sequelae of ischemic stroke in children.LATEST DEVELOPMENTSHigh-quality evidence has resulted in an organized approach to emergent treatment of ischemic stroke in adults, but most front-line providers are less prepared for emergent stroke management in children. The level of evidence for reperfusion therapies in children remains low but is growing. Thrombolysis and thrombectomy are sometimes considered for hyperacute treatment of stroke in children. Readiness for pediatric stroke at regional centers should include an organized approach to pediatric stroke triage and management based on extrapolation from adult stroke trials, expert consensus, and emerging pediatric studies.ESSENTIAL POINTSThis review provides up-to-date information about ischemic stroke risk factors and management in children. Preparation for rapid stroke diagnosis and management in children may improve outcomes.

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Section: Pediatric Stroke Risk Factorsmentioning

confidence: 99%

Section: Complex Cardiac Diseasementioning

confidence: 99%

Section: Pediatric Stroke Risk Factorsmentioning

confidence: 99%

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Pediatric Ischemic Stroke

Fox¹

2023

CONTINUUM: Lifelong Learning in Neurology

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“…Patients with AIS were also found to have atrioventricular septal defects, Ebstein anomaly, arrhythmias, and cardiomyopathy secondary to myocarditis 22 . Additionally, patients who undergo cardiac catheterization or cardiac surgery are at an increased risk 23,24 . Patients who require ventricular assist devices are also at an increased risk of AIS although hemorrhagic strokes can occur 25,26 …”

Section: Etiologymentioning

confidence: 99%

Pediatric stroke in the emergency department

Baldovsky

Okada

2020

JACEP Open

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“…Congenital heart defects and acquired cardiovascular diseases may be considered as independent causes of an AIS in children, while in 30% of children, secondary cerebral ischemia develops during procedures related to the treatment of these conditions [7]. AIS may also occur in children after cardiac catheterization [8].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Post-Stroke Consequences in Pediatric Ischemic Stroke in the Context of Neuroimaging Results—Experience from a Single Medical Center

et al. 2021

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Arterial ischemic stroke (AIS) in children is a rare condition; its frequency is estimated at 0.58 to 7.9 new onsets in 100,000 children per year. The knowledge on risk factors, clinical outcomes and consequences of pediatric AIS is increasing. However, there are still many unknowns in the field. The aim of the study was to analyze the clinical presentation of pediatric AIS and its consequences according to the neuroimaging results and location of ischemia. The research was retrospective and observational. The analyzed group consisted of 75 AIS children (32 girls, 43 boys), whereby the age of the patients ranged from 9 months to 18 years at stroke onset. All the patients were diagnosed and treated in one tertiary center. The most frequent stroke subtype was total anterior circulation infarct (TACI) with most common ischemic focus location in temporal lobe and vascular pathology in middle cerebral artery (MCA). The location of ischemic focus in the brain correlated with post-stroke outcomes: intellectual delay and epilepsy, hemiparesis corresponded to the location of vascular pathology. A correlation found between ischemic lesion location and vascular pathology with post-stroke consequences in pediatric AIS may be important information and helpful in choosing proper early therapy. The expected results should lead to lesser severity of late post-stroke outcomes.

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Stroke After Cardiac Catheterization in Children

Cited by 10 publications

References 17 publications

Pediatric Ischemic Stroke

Pediatric Ischemic Stroke

Pediatric stroke in the emergency department

Assessment of Post-Stroke Consequences in Pediatric Ischemic Stroke in the Context of Neuroimaging Results—Experience from a Single Medical Center

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