The Cerebrovascular Disorders and Stroke (CVD and Stroke) Program at Boston Children's Hospital is committed to providing the most advanced treatments to children with stroke. We are one of a few specialized teams in the Unites States dedicated to understanding, preventing and treating pediatric strokes.
- We look at the whole picture, not just the immediate problem. In addition to addressing the stroke, we quickly evaluate the underlying causes so we can prevent future strokes. In addition, we provide resources to help children with stroke and their parents deal with the consequences of stroke that can be encountered at home and in school.
- Our team works continuously to improve the current treatment for pediatric strokes, and is investigating the use of tPA treatment, the gold standard in treating adult acute-onset strokes, in children.
- We use all the resources at Boston Children's to provide expert, multidisciplinary care to your child. For example, Dr. Darren Orbach, our interventional neuroradiologist, uses minimally invasive techniques to treat certain patients with cerebrovascular disorders and stroke. As a result, Dr. Orbach is a very important member of the acute response stroke team at Boston Children's. You can read more about the interventional neuroradiological services at Boston Children's.
Clinical Trials and Research
The Cerebrovascular Disorders and Stroke Program (CVD and Stroke) at Boston Children's Hospital is one of the most active pediatric stroke research centers ... both clinically and in the laboratory.
- Dr. Michael Rivkin is the site investigator for the International Pediatric Stroke Study. This collaborative research project will increase the understanding of neonatal and childhood stroke by collecting standardized data on the diagnosis, investigation, treatment and outcome of children with stroke. Ultimately, the study's data will lead to clinical trials for children with stroke.
In addition, Dr. Rivkin is the principal investigator for the Boston Children's site in "The Vascular Effects of Infection in Pediatric Stroke," a NIH-funded multicenter study of stroke in children.
- Dr. Darren Orbach's clinical research on central nervous system (CNS) and non-CNS head and neck vascular anomalies flows naturally from the hospital’s wide clinical referral base.
- Dr. Rivkin and Dr. Amy Danehy are investigating non-invasive perfusion magnetic resonance imaging as a method to look at the brain's blood supply and circulation in children who ar having or have had a stroke. This is beneficial because:
- Injection of dye for use as intravascular contrast is not necessary
- No IV is needed for performance of the study
- There is no risk of damaging or rupturing a blood vessel
- Clinical scientists at Boston Children's are currently developing a pilot study to evaluate systemic versus local administration of thrombolytic agents based on the onset of symptoms.
Basic science researchers in our laboratories are studying brain development, plasticity and adaptation. Their discoveries will improve our understanding of the age-related causes and effects of stroke, and will help us develop better treatments.
- Neuroscientist Dr. Larry Benowitz has found that inosine, a naturally occurring cellular compound, improves motor function after spinal cord injury or stroke. He and Dr. Rivkin are pursuing the possibility of using this agent as a treatment to improve neurologic function following stroke in children.
- Dr. Darren Orbach's basic research revolves around the development of a high-speed MR technique for directly imaging rapid neuronal activity. The high-speed MR technique is currently being used to help further the understanding of the pathophysiology of various epilepsy syndromes.
- Dr. Cameron Trenor's research aims to understand the mechanism of small artery blood clot formation, similar to what occurs in some stroke patients. He is also interested in vascular anomalies, which can lead to stroke or bleeding around or within the brain.
- Dr. Edward Smith's research is primarily centered on understanding the molecular mechanisms of tumorigenesis and angiogenesis in the central nervous system. This work has included basic science and translational studies investigating adult and pediatric brain tumors, Moyamoya disease and cerebral vascular malformations.
In addition, another of Dr. Smith's major research interests, in conjunction with the lab of Marsha Moses, PhD, director of the Vascular Biology Program, is the study of pediatric cerebral arteriovenous malformations (AVMs).
- Researchers are actively involved in international research studying the role of transfusion and hydroxyurea in sickle cell patients with stroke or with increased stroke risk as predicted by abnormal transcranial Doppler ultrasound studies. The director of Children's Sickle Cell Program, Dr. Matthew Heeney, and Dr. Rivkin are active collaborators in these efforts.
Researching the Use of Thrombolitic Therapy in Children