Pediatric Stroke: Unique Implications of the Immature Brain on Injury and Recovery

Abstract

Pediatric stroke causes significant morbidity for children resulting in lifelong neurological disability. Although hyperacute recanalization therapies are available for pediatric patients, most patients are ineligible for these treatments. Therefore the mainstay for pediatric stroke treatment relies on rehabilitation to improve outcomes. Little is known about the ideal rehabilitation therapies for pediatric patients with stroke and the unique interplay between the developing brain and our models of stroke recovery. In this review, we first discuss the consequences of pediatric stroke. Second, we examine the scientific evidence that exists between the mechanisms of recovery and how they are different in the pediatric developing brain. Finally, we evaluate potential interventions that could improve outcomes.

Coronavirus Infections in the Nervous System of Children: A Scoping Review Making the Case for Long-Term Neurodevelopmental Surveillance

“…However, with all etiologies of pediatric stroke there is a great of variability in the extent of these deficits in the existing literature. 68 Therefore, in the absence of current clinical knowledge of pediatric recovery following SARS-CoV-2 stroke, consideration of the extent of injury and a child’s early clinical course can guide aggressiveness of rehabilitation. However, even if major deficits are not present, children with cerebrovascular disease associated with HCoV infections should undergo neurodevelopmental follow-up for evaluation of deficits resulting from minor disruptions in neural connectivity.…”

The Effect of Bilingual Exposure on Language and Cognitive Development in Children Following Ischemic Stroke

“…Vulnerability during “sensitive periods” of development leave children open to the risk of further disruption in development, building on previous milestones 5 . Recovery has been conceptualized as categorical change on the PSOM severity classification system over time 13,26 ; as assessed in the Recurrence and Recovery Questionnaire (based on the PSOM) 36 ; and more generally, through a restoration/restitution of function or an adaptative compensation through substitution 37 . Recovery as it relates to post-stroke outcomes is predominantly used in the literature, though development is an intrinsically related concept.…”

“…Recovery as it relates to poststroke outcomes is predominantly used in the literature, though development is an intrinsically BILINGUAL STROKE DEVELOPMENT related concept. As such, conflation of these terms further complicate the situation of atypicallydeveloping populations (34). This is the first study evaluating the effect of bilingualism on language and cognitive development post-stroke.…”

Efecto de la rehabilitación neuropsicológica en la enfermedad vascular cerebral en etapa crónica en adolescentes. Estudio de caso

“…1 La EVC en jóvenes es más heterogénea respecto a la observada en adultos mayores, debido a la inmadurez cerebral aún presente, a la variedad de posibles factores de riesgo subyacentes y a la etiología de la lesión. 2,3 Respecto a las secuelas cognitivas de la EVC, se ha encontrado presencia de alteración en atención, funciones ejecutivas, menor desempeño intelectual, bajo rendimiento académico, así como fallas en la regulación emocional y conductual que suelen persistir hasta más de seis años. 4 Se ha descrito que la rehabilitación neuropsicológica (RN), al promover un mejor estado cognitivo de pacientes post-EVC, puede impactar de manera positiva el estado emocional y calidad de vida, 5 lo que podría contemplarse como una estrategia terapéutica viable para dar frente a las secuelas del EVC en jóvenes.…”