Spontaneous carotid and vertebral artery dissection in children

Camacho, Ana; Villarejo, Alberto; Aragón, Ana Martínez de; Simón, Rogelio; Mateos, Fernando

doi:10.1016/s0887-8994(01)00294-6

Cited by 43 publications

(19 citation statements)

References 14 publications

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“…Limited retrospective data suggest an incidence of approximately 2.5 to 3.1 cases per 100,000 children per year (1). Whereas cervical artery dissection accounts for only 2% of stroke in adults, it may be responsible for up to 20% of stroke in childhood and adolescence (2). As in adults, carotid artery dissection is much more common than VAD (1,3,4).…”

Section: Discussionmentioning

confidence: 99%

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A Preschool-Age Child With First-Time Seizure and Ataxia

Papp

Dorsey

2009

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

“…Conventional angiography remains the gold standard for diagnosis of cervical artery dissection, and may demonstrate luminal stenosis, aneurysmal dilatation, or the most specific finding, an intimal flap (2,4). Newer noninvasive imaging modalities are now widely available, and are particularly preferable in children.…”

Section: Discussionmentioning

confidence: 99%

A Preschool-Age Child With First-Time Seizure and Ataxia

Papp

Dorsey

2009

The Journal of Emergency Medicine

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“…Similarly, although controversial, anticoagulation is widely used in patients with cervical arterial dissection with the aim of reducing the risk of recurrent embolic stroke (Camacho et al 2001, Fullerton et al 2001, Beletsky et al 2003. In moyamoya syndrome, AIS is usually haemodynamically mediated and surgical revascularization may be considered.…”

Section: Development Of the Proposed Pscmentioning

confidence: 99%

A proposed classification for subtypes of arterial ischaemic stroke in children

Wraige¹,

Pohl²,

Ganesan³

2005

Dev Med Child Neurol

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The aim of this study was to propose a classification system for childhood arterial ischaemic stroke (AIS). Subtypes from the Trial of Org 10172 in Acute Stroke Therapy (TOAST) classification, previously shown to be applicable to children, were retained in the proposed Paediatric Stroke Classification (PSC). Additional important paediatric AIS aetiologies were identified from a literature review. Preliminary validation was performed by three raters who categorized clinical vignettes from 135 patients (66 male; median age 6.3 y, range 0.1 to 16 y). Eight aetiological subtypes were identified and defined, as follows: (1) sickle cell disease; (2) cardioembolic; (3) moyamoya syndrome; (4) cervical arterial dissection; (5) steno-occlusive cerebral arteriopathy; (6) other determined aetiology; (7) multiple probable/possible aetiologies; and (8) undetermined aetiology. There was very good agreement between the raters about categorization of the vignettes. Causes of disagreement were identified and final categories and definitions were modified accordingly. We conclude that the PSC enables the categorization of children with AIS into aetiological subtypes relevant to this age group. This will be useful in multicentre studies of natural history and treatment but will require further independent validation.

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“…Thrombosis (traumatic or due to fibrodysplasia) of the common, vertebral and basilar carotid arteries has rarely been reported 8,12,25,34 .…”

Section: Classification and Clinical Presentationmentioning

confidence: 99%

Paediatric Cerebrovascular Disease: Neuroradiological Diagnosis

Polonara

Bove

Regnicolo

et al. 2005

Rivista di Neuroradiologia

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The low incidence (2.6 cases in 100,000) of cerebrovascular disease in paediatric patients compared with the adult population makes it a diagnostic challenge. Etiological factors have changed over time: whereas in the past bacterial meningitis was the most frequent cause, heart disease, haematological disorders, vasculopathy and viral infections have now become the most common. Haemorrhagic stroke is most frequently due to arteriovenous malformations (AVMs), cavernous angioma, haematological disorders and intracranial aneurysms. Traumatic or fibrodyplastic arterial thrombosis is extremely rare. Venous thrombosis most commonly affects the upper sagittal sinus. In two thirds of cases the cause of stroke remains unknown. For years, symptoms of acute CNS deficits have been studied with computed tomography (CT), especially to rule out haemorrhage. To avoid exposing paediatric patients to ionizing radiation, magnetic resonance imaging (MRI), more sensitive and specific for the identification of acute ischaemic stroke, is currently the first-line diagnostic technique. In particular, diffusion-weighted sequences are capable of early identification of ischaemic areas. Association with perfusion techniques will define the areas at high risk of further damage and to attempt to estimate the final volume of the lesion. MR spectroscopy contributes to the characterization of ischaemic lesions. MR angiography (MRA) has proved to be a noninvasive technique with the same diagnostic effectiveness as conventional angiography for dissections, transient cerebral arteriopathy and moyamoya. The cervical arteries are studied using contrast-enhanced sequences. Conventional angiography remains the technique of choice for the study of small vessels disease and AVMs.

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Spontaneous carotid and vertebral artery dissection in children

Cited by 43 publications

References 14 publications

A Preschool-Age Child With First-Time Seizure and Ataxia

A Preschool-Age Child With First-Time Seizure and Ataxia

A proposed classification for subtypes of arterial ischaemic stroke in children

Paediatric Cerebrovascular Disease: Neuroradiological Diagnosis

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