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Program spotlight: Cerebrovascular Disorders and Stroke Program

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.

What our CVD and Stroke Program offers
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

Research studies underway
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.

When to refer
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 the body
  • 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.

Meet the Team

Michael J. Rivkin, MD
Director, CVD and Stroke Program; neurologist

 

 


Cameron C. Trenor, III, MD
Co-Director, CVD and Stroke Program; hematologist

 

 


Edward R. Smith, MD
Co-Director, CVD and Stroke Program; neurosurgeon

 

 


Amy Danehy, MD
Neuroradiologist

 

 


Rebekah Mannix, MD, MPH
Emergency Medicine Physician





Darren B. Orbach, MD, PhD
Neurointerventional Radiologist





Kathy Harney, C-PNP





R. Michael Scott, MD
Neurosurgeon-in-Chief
Christopher K. Fellows Family Chair in Pediatric Neurosurgery




Lindsay Simmons, CNRN
Clinical Coordinator



 


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

 

 
 
 

Cerebrovascular Disorders and Stroke Program

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Facts on CVD and Stroke

  • Cerebrovascular disorders are among the top 10 causes of death in children Stroke in childhood adversely affects development and can result in deficits that last decades.
  • Neurologic deficits occur in 65 percent of children with stroke. Approximately 4.5 percent of children with arterial ischemic stroke die as a result of their condition.
  • Recurrent stroke occurs in 10 to 25 percent of all older infants and children with stroke. Cumulative five-year recurrence can be as high as 65 percent in children with documented cerebrovascular abnormalities