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The Cerebrovascular Disorders and Stroke Program at Boston Children's Hospital is one of a few specialized programs in the Unites States dedicated to understanding, preventing and treating childhood strokes. We are one of the most active pediatric stroke research centers in the world—both clinically and in the laboratory—working continually to improve treatments. Our multidisciplinary team at Boston Children’s Hospital is one of a small group of pediatric primary stroke centers in North America, working to establish a 24/7 standardized care program for children with stroke.
Boston Children’s participates in three major multi-center studies of pediatric stroke:
Michael Rivkin, MD, discusses research underway to treat pediatric strokes with clot-busting drugs, similar to those used to treat adult strokes.
The current standard of care for adults, if the stroke is caught early, is to give intravenous tissue plasminogen activator (tPA) to dissolve any blood clot that might be causing the stroke. Boston Children's Cerebrovascular Disorders and Stroke program served as a primary enrollment center and Core Imaging Center for the NIH-funded Thrombolysis in Pediatric Stroke (TIPS) study, which investigated IV tPA treatment for children presenting with 4.5 hours of onset of acute ischemic stroke. Recent published studies led by investigators in the Cerebrovascular Disorders and Stroke Program found that providing TIPS training to pediatric centers significantly increased their readiness to treat children with acute stroke.
Led by Michael Rivkin, MD, Laura Lehman, MD, and Cameron Trenor, MD, this collaborative research project is collecting standardized data on the diagnosis, investigation, treatment and outcome of children with stroke, to better understand stroke conditions in newborns and older children. The information is shared in an international data repository used to help practitioners around the world better understand stroke in children. Ultimately, the study's data will lead to clinical trials.
This NIH-funded multicenter study, led by Michael Rivkin, MD, is exploring the hypothesis that infection can lead to arterial ischemic stroke in children by injuring the blood vessels, and that the resulting arterial damage and biochemical markers of inflammation can predict additional stroke.
Treatment of seizures in newborns after brain injury
A pilot study is testing bumetanide to treat seizures caused by focal or multi-focal stroke, intracranial hemorrhage or hypoxic-ischemic encephalopathy that are not controlled by phenobarbital.
Blood clot formation
Research by Cameron Trenor, MD, 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.
Cognitive outcomes after stroke in childhood
Christine Mrakotsky, PhD, is studying children with extensive neuropsychological evaluations to determine the ways in which stroke affects children’s developing cognition.
Basic laboratory research may eventually improve our treatment of stroke and help children recover from its effects.
Darren Orbach, MD, PhD, is conducting basic research 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.
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”