Emergency management of ischemic stroke in children.

Steinlin, Maja; Mackay, Mark T (2015). Emergency management of ischemic stroke in children. Current treatment options in neurology, 17(5), p. 349. Current Medicine Group LLC 10.1007/s11940-015-0349-2

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OPINION STATEMENT Children who present with acute neurological symptoms suggestive of a stroke need immediate clinical assessment and urgent neuroimaging to confirm diagnosis. Magnetic resonance imaging (MRI) is the investigation of first choice due to limited sensitivity of computed tomography (CT) for detection of ischaemia. Acute monitoring should include monitoring of blood pressure and body temperature, and neurological observations. Surveillance in a paediatric high dependency or intensive care unit and neurosurgical consultation are mandatory in children with large infarcts at risk of developing malignant oedema or haemorrhagic transformation. Thrombolysis and/or endovascular treatment, whilst not currently approved for use in children, may be considered when stroke diagnosis is confirmed within 4.5 to 6 h, provided there are no contraindications on standard adult criteria. Standard treatment consists of aspirin, but anticoagulation therapy is frequently prescribed in stroke due to cardiac disease and extracranial dissection. Steroids and immunosuppression have a definite place in children with proven vasculitis, but their role in focal arteriopathies is less clear. Decompressive craniotomy should be considered in children with deteriorating consciousness or signs of raised intracranial pressure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Steinlin, Maja

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1092-8480

Publisher:

Current Medicine Group LLC

Language:

English

Submitter:

André Schaller

Date Deposited:

08 Apr 2016 13:32

Last Modified:

08 Apr 2016 13:32

Publisher DOI:

10.1007/s11940-015-0349-2

PubMed ID:

25854652

URI:

https://boris.unibe.ch/id/eprint/79373

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