Arteriopathy in pediatric stroke: an underestimated clinical entity

ABSTRACT Background: Pediatric arterial ischemic stroke (AIS), which was thought to be a rare disorder, is being increasingly recognized as an important cause of neurological morbidity, thanks to new advances in neuroimaging. Objective: The aim of this study was to review the main etiologies of stroke due to arteriopathy in children. Methods: Using a series of cases from our institution, we addressed its epidemiological aspects, physiopathology, imaging findings from CT, MR angiography, MR conventional sequences and MR DWI, and nuclear medicine findings. Results: Through discussion of the most recent classification for childhood AIS (Childhood AIS Standardized Classification and Diagnostic Evaluation, CASCADE), we propose a modified classification based on the anatomical site of disease, which includes vasculitis, varicella, arterial dissection, moyamoya, fibromuscular dysplasia, Takayasu's arteritis and genetic causes (such as ACTA-2 mutation, PHACE syndrome and ADA-2 deficiency). We have detailed each of these separately. Conclusions: Prompt recognition of AIS and thorough investigation for potential risk factors are crucial for a better outcome. In this scenario, neurovascular imaging plays an important role in diagnosing AIS and identifying children at high risk of recurrent stroke.

Bibliographic Details

Main Authors:	PIZZATTO,Ronaldo, RESENDE,Lucas Lopes, LOBO,Carlos Felipe Teixeira, NEVES,Yuri Costa Sarno, PAZ,José Albino da, ALVES,César Augusto Pinheiro Ferreira, LEITE,Claudia da Costa, LUCATO,Leandro Tavares
Format:	Digital revista
Language:	English
Published:	Academia Brasileira de Neurologia - ABNEURO 2021
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400321
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