Management of Stroke in Infants and Children : A Scientific Statement From a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young

• Published in: Stroke (1970) Vol. 39; no. 9; pp. 2644 - 2691
• Main Authors: ROACH, E. Steve, GOLOMB, Meredith R, SMITH, Edward R, ADAMS, Robert, BILLER, Jose, DANIELS, Stephen, DEVEBER, Gabrielle, FERRIERO, Donna, JONES, Blaise V, KIRKHAM, Fenella J, SCOTT, R. Michael
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.09.2008
• Subjects: Age Factors; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - drug therapy; Anticoagulants - administration & dosage; Biological and medical sciences; Brain Ischemia - drug therapy; Brain Ischemia - prevention & control; Child; Child, Preschool; Evidence-Based Medicine; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Infant; Infant, Newborn; Intracranial Embolism - drug therapy; Intracranial Embolism - etiology; Intracranial Embolism - prevention & control; Intracranial Hemorrhages - drug therapy; Intracranial Hemorrhages - prevention & control; Medical sciences; Moyamoya Disease - complications; Moyamoya Disease - drug therapy; Nervous system (semeiology, syndromes); Neurology; Stroke - drug therapy; Stroke - prevention & control; Vascular diseases and vascular malformations of the nervous system; Human; Stroke; Nervous system diseases; Infant; Cardiovascular disease; Cerebral disorder; AHA Scientific Statements; Vascular disease; Clinical management; children; Central nervous system disease; Child; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.108.189696

The purpose of this statement is to review the literature on childhood stroke and to provide recommendations for optimal diagnosis and treatment. This statement is intended for physicians who are responsible for diagnosing and treating infants, children, and adolescents with cerebrovascular disease. The Writing Group members were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee. The panel included members with several different areas of expertise. Each of the panel's recommendations was weighted by applying the American Heart Association Stroke Council's Levels of Evidence grading algorithm. After being reviewed by panel members, the manuscript was reviewed by 4 expert peer reviewers and by members of the Stroke Council Leadership Committee and was approved by the American Heart Association Science Advisory and Coordinating Committee. We anticipate that this statement will need to be updated in 4 years. Evidence-based recommendations are provided for the prevention of ischemic stroke caused by sickle cell disease, moyamoya disease, cervicocephalic arterial dissection, and cardiogenic embolism. Recommendations on the evaluation and management of hemorrhagic stroke also are provided. Protocols for dosing of heparin and warfarin in children are suggested. Also included are recommendations on the evaluation and management of perinatal stroke and cerebral sinovenous thrombosis in children.