Conventional cerebral angiography in children with ischemic stroke (original) (raw)
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Paediatrics Today, 2014
Objective-To describe the magnetic resonance imaging (MRI) and time-of-flight (TOF)-magnetic resonance angiography (MRA) characteristics of children with arterial ischemic stroke and correlate them with the aetiology. Methods-We performed a retrospective review of clinical records and imaging (MRI and MRA) of 34 children (8 months to 17 years) with arterial ischemic stroke. Results-The group contained 14 females and 20 males. Risk factors were congenital heart disease (CHD) in 8, sickle cell disease in 2, prothrombotic abnormalities in 7, vasculitis in 5 (varicella in 2, neuroborreliosis in 1), trauma in 3, steno-occlusive cerebral arteriopathy, herniation due to intracranial bleeding, complication of aneurysmal subarachnoid haemorrhage with vasospasm, and arterial dissection with and without previous trauma. In 5 of the 34 patients the aetiology was undetermined. The most common infarctions were observed in the distribution of the middle cerebral artery, followed by the posterior circulation. The intracranial MRA was normal in 15 of the 34 children. In all but one patient with cryptogenic stroke MRA was normal. Conclusion-MRI is helpful to determine the exact location and limit of the infarct zone. The absence of cerebral arteriopathy on TOF-MRA in childhood stroke suggests a nonvascular cause; mainly cryptogenic stroke, but also prothrombotic abnormalities and CHD.
AJNR. American journal of neuroradiology, 2000
We report our experience with MR imaging, MR angiography, and catheter angiography in children with acute idiopathic cerebral infarction and suggest that catheter angiography may still play an important role in this setting. During the past 8 years, 18 children with idiopathic cerebral infarction underwent MR imaging and catheter angiography; 17 were also studied with MR angiography. MR imaging was done within 34 hours after onset of hemiplegia or seizures or both. Sixteen patients underwent catheter angiography within 36 hours of MR imaging; 12 studies were performed within 22 hours. Two patients underwent catheter angiography, in both cases within 72 hours. Infarcts were compared with arterial abnormalities seen at catheter angiography, and the results of MR angiography were compared with those seen at catheter angiography. Comparing MR angiography with catheter angiography, we found the positive predictive value of MR angiography for arteriopathy was 100%, with a negative predict...
Magnetic Resonance Angiography in Childhood Arterial Brain Infarcts
Stroke, 2002
Background and Purpose — Contrast angiography (CA) is the reference examination for the diagnosis of cerebral arterial abnormality, but this procedure is invasive. In childhood, ischemic strokes are being increasingly investigated by means of MRI, including MR angiography (MRA). Very few data are available about the accuracy of MRA compared with CA in the specific context of acute pediatric stroke. We sought to compare the results of MRA with those of CA for the study of cerebral arteries in children with arterial infarction in an arterial distribution. Methods — Twenty-four children presenting with 26 infarcts were studied. All were examined with cerebral MRI and MRA and with CA. The interval between CA and MRA was <3 days for most of the patients. Results — Arterial lesions were detected in all but 2 children. They were located in the major cerebral arteries, predominantly in the anterior circulation (85% of cases). All lesions shown by CA were present on MRA (19 cases). Patien...
Pediatric Stroke: Clinical Findings and Radiological Approach
Stroke Research and Treatment, 2011
This paper focuses on radiological approach in pediatric stroke including both ischemic stroke (Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis) and hemorrhagic stroke. Etiopathology and main clinical findings are examined as well. Magnetic Resonance Imaging could be considered as the first-choice diagnostic exam, offering a complete diagnostic set of information both in the discrimination between ischemic/hemorrhagic stroke and in the identification of underlying causes. In addition, Magnetic Resonance vascular techniques supply further information about cerebral arterial and venous circulation. Computed Tomography, for its limits and radiation exposure, should be used only when Magnetic Resonance is not available and on unstable patients.
Magnetic Resonance Angiography and Brain Ischemia in Patients with Acute Stroke
2012
OBJECTIVE: The purpose of the study is to see presence of arterial diseases on Magnetic Resonance Angiography (MRA) and diffusion positive infarction in patients with acute ischemic stroke. STUDY DESIGN: Cross-sectional conducted at Radiology department of the Aga Khan University Hospital. METHODS: 124 patients with signs and symptoms of cerebral ischemia were referred for study. 16 patients could not complete the study because of poor cooperation and MRA was not done. 108 patients completed all sequences of the study according to departmental protocol. MRA findings were evaluated with presence of acute brain ischemia on magnetic resonance imaging. Chi square test was applied to see whether arterial disease on MRA correlated with brain parenchymal abnormality on MRI. p-value less than 0.05 were considered as significant. RESULTS: In majority of patients (95.34%) the arterial lesion on MRA correlated with acute infarction on MRI (p-value 0.001). 40 patients had arterial abnormality o...
Imaging Features of Arterial Ischemic Stroke in a 13 Year Old Boy - an Interesting Case Report
2017
Childhood arterial ischemic stroke is a rare disease with an estimated incidence of 2-13/100000 per year 1,13 . Variability in the clinical presentation, the inability of children to effectively communicate their symptoms, lack of early clinical suspicion and overlapping of symptoms with many other diseases gives rise to delay in the diagnosis and delayed treatment. This leads to multiple long term co morbidity, disability and socioeconomic dependency with affected quality of life. The causes and risk factors of childhood ischemic stroke are manifold and inter related, differing greatly from that of adult ischemic stroke and needs a comprehensive diagnostic work up. The etiology should be accurately deduced since future recurrence rates depend on the etiology and so are the specific treatments with medical management like steroids for vasculitis or surgery or minimally invasive endovascular options for stenotic lesions.
Ischemic stroke in infancy, childhood, and adolescence
Child's Nervous System, 1988
The authors studied 34 patients with juvenile ischemic cerebrovascular disease over a 15-year period. Of the 34 patients, 23 had intracranial occlusions attributed to cerebral thrombosis or embolism and 11 had occlusions resulting from moyamoya disease. Clinicopathological features were evaluated in the 23 cases with ischemic stroke, but not those with moyamoya disease. The cause of the arterial occlusion remained undetermined in 11 patients and was found to be an embolism based on congenital heart disease in 8, on trauma in 3, and on infection in 1. Cerebral angiography was performed in 21 patients. Of these, 17 had stenoses or occlusions corresponding to their symptoms. CT scans were performed in 10 patients; the lesion in question showed no stenosis or occlusion with cerebral angiography. With regard to prognosis, patients with u n k n o w n etiology had good outcomes compared with those with congenital heart disease. With respect to "acute infantile hemiplegia", 10 patients had convulsive seizures and 4 had a history of an earlier infection. Angiography and CT scans in patients with congenital heart disease demonstrated arterial occlusive sites in the middle cerebral artery region. Three patients had abscesses after their ischemic lesions.
MR angiography in acute cerebral ischemia of the anterior circulation: a preliminary report
AJNR. American journal of neuroradiology, 1997
To determine the prevalence of major vessel occlusion in cases of acute cerebral ischemia of the anterior circulation by using MR angiography and to assess the frequency of spontaneous thrombolysis. Thirty patients with an initial clinical diagnosis of possible acute stroke of the anterior circulation made within 24 hours of the event were studied with conventional T2-weighted MR imaging and with two-dimensional and three-dimensional time-of-flight MR angiography. Studies were repeated if the initial study showed partial or complete occlusion. Of the 30 patients studied six (20%) had a final diagnosis of a transient ischemic attack and 24 (80%) had a stroke of the anterior circulation as confirmed by T2 abnormalities and persistence of clinical symptoms. Twelve (50%) of the stroke patients had a major vessel abnormality, either partial or complete occlusion, at MR angiography. Of these 12 patients, nine subsequently had follow-up MR angiography, and only two of these had a change in...
Einstein (São Paulo, Brazil)
We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy.