The Cerebrovascular Disorders and Stroke (CVD and Stroke) Program at Children's Hospital Boston offers rapid diagnosis and treatment from a team of subspecialists who deliver treatment that minimizes long-term damage to the brain.
About 13 in 100,000 children over 1 month of age suffer a stroke each year, typically arterial ischemic strokes that result from blood clotting abnormalities, vascular malformations and other abnormalities, inflammation, viral infections or other genetic conditions. The incidence is much higher in neonates, with one in 4,000 suffering a stroke before, during or soon after birth.
Our stroke team includes Neurology, Neurosurgery, Hematology, Neuro-radiology, Neurointerventional Radiology and Emergency Medicine specialists who provide:
- rapid multi-system evaluation using advanced laboratory and imaging studies that identify whether a stroke occurred, as well as its underlying cause
- immediate triage to a neurosurgeon for clot removal, vascular malformation repair or to release pressure in the brain, if necessary
- access to a minimally invasive neurointerventional radiologist skilled in state-of-the-art techniques to eliminate blockages, if open surgery isn't required
- referral to physical therapists, occupational therapists, speech and language therapists and neuropsychologists who help children address and improve any affected functions
- long-term multidisciplinary care to prevent additional strokes
Laboratory studies at Children's evaluate brain development, plasticity and adaptation and aim to help improve understanding of the age-related causes and effects of stroke.
We participate in the International Pediatric Stroke Study, which is designed to increase understanding of neonatal and childhood stroke by collecting standardized data on the diagnosis, investigation, treatment and outcome of children with stroke.
Clinical investigators are developing a pilot study to investigate systemic versus local administration of thrombolytic agents based on the onset of symptoms.
Less obvious signs of stroke in children include headache, a change in mental status or weakness. In general, we recommend rapid referral to a pediatric stroke center if these symptoms occur at the same time:
- weakness on one side of
- loss of vision
- ataxia or difficulty maintaining gait stability
- loss of expressive or receptive language function
- loss of sensation on one side
of the body
- new, unexplained seizure, especially if followed by
post-ictal lateralized weakness
- sudden alteration of consciousness
Early identification is crucial in minimizing long-term disabilities, and we encourage immediate evaluation for any patient you suspect is suffering from a stroke.
Director, CVD and Stroke Program; neurologist
Trenor, III, MD
Co-Director, CVD and Stroke Program; hematologist
Co-Director, CVD and Stroke Program; neurosurgeon
Rebekah Mannix, MD, MPH
Emergency Medicine Physician
Darren B. Orbach,
Kathy Harney, C-PNP
R. Michael Scott, MD
Christopher K. Fellows Family Chair in Pediatric Neurosurgery
Lindsay Simmons, CNRN
Deborah Waber, PhD
Senior Associate in Psychology
More information: childrenshospital.org/pedistroke
Urgent contact: 617-355-6369, Pager # 6159 available 24
hours a day, 7 days a week