Abstract:
:Ischemic and hemorrhagic stroke can occur in the setting of pediatric trauma, particularly those with head or neck injuries. The risk of stroke appears highest within the first two weeks after trauma. Stroke diagnosis may be challenging due to lack of awareness or concurrent injuries limiting detailed neurological assessment. Other injuries may also complicate stroke management, with competing priorities for blood pressure, ventilator management, or antithrombotic timing. Here we review epidemiology, clinical presentation, and diagnostic approach to blunt arterial injuries including dissection, cerebral sinovenous thrombosis, mineralizing angiopathy, stroke from abusive head trauma, and traumatic hemorrhagic stroke. Owing to the complexities and heterogeneity of concomitant injuries in stroke related to trauma, a single pathway for stroke management is impractical. Therefore providers must understand the goals and possible costs or consequences of stroke management decisions to individualize patient care. We discuss the physiological principles of cerebral perfusion and oxygen delivery, considerations for ventilator strategy when stroke and lung injury are present, and current available evidence of the risks and benefits of anticoagulation to provide a framework for multidisciplinary discussions of cerebrovascular injury management in pediatric patients with trauma.
journal_name
Pediatr Neuroljournal_title
Pediatric neurologyauthors
Galardi MM,Strahle JM,Skidmore A,Kansagra AP,Guilliams KPdoi
10.1016/j.pediatrneurol.2019.12.009subject
Has Abstractpub_date
2020-07-01 00:00:00pages
5-12eissn
0887-8994issn
1873-5150pii
S0887-8994(19)30999-3journal_volume
108pub_type
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journal_title:Pediatric neurology
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journal_title:Pediatric neurology
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journal_title:Pediatric neurology
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Pediatric neurology
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journal_title:Pediatric neurology
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journal_title:Pediatric neurology
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