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- Perspective and Pathogenesis
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1. Expanding frontiers of cerebrovascular disease
- Prof. Vladimir Hachinski
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2. Basic anatomy, physiology and pathophysiology of the cerebral circulation for the physician
- Prof. Jean-Claude Baron
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3. Pathophysiology of cerebral ischemia
- Prof. Wolf-Dieter Heiss
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4. Intracerebral hemorrhages: causes and clinical findings
- Prof. Louis Caplan
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5. Subarachnoid hemorrhage (SAH)
- Prof. R. Loch Macdonald
- Diagnosis
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6. Clinical diagnosis of stroke and subtypes
- Prof. Louis Caplan
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7. The investigation of stroke
- Dr. Bart Demaerschalk
- Treatment
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8. Acute therapy of stroke and reperfusion treatments
- Prof. Brian Silver
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9. Subarachnoid hemorrhage diagnosis and management
- Prof. Gary K. Steinberg
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10. Stroke-induced heart injury
- Dr. Luciano A. Sposato
- Rehabilitation
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11. Stroke rehabilitation: principles of stroke
- Prof. Robert Teasell
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12. Stroke rehabilitation: therapies and treatments
- Prof. Robert Teasell
- Prevention
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13. Lifestyle and nutrition in stroke prevention
- Prof. J. David Spence
- Special Topics
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15. Pediatric stroke: cerebrovascular injury in the developing brain
- Prof. Adam Kirton
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16. Stroke in women: epidemiology, risk and prevention
- Prof. Cheryl Bushnell
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17. Transient ischemic attack and cognition
- Dr. Jennifer Mandzia
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18. Vascular cognitive impairment
- Prof. Eric E. Smith
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19. Atrial fibrillation, anticoagulation and vitamins for homocysteine
- Prof. J. David Spence
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20. Stroke in the young adult
- Prof. Jeffrey Saver
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21. Stroke in the young
- Dr. Gyan Kumar
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22. Convergence and joint prevention of stroke and dementia
- Prof. Vladimir Hachinski
- Archived Lectures *These may not cover the latest advances in the field
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23. Vascular cognitive impairment
- Dr. John Bowler
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24. Pediatric stroke
- Dr. Gabrielle deVeber
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25. The deteriorating stroke
- Prof. Werner Hacke
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26. General management
- Prof. Bo Norrving
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27. The treatment of stroke: specific management - thrombolysis plus
- Prof. Nils Wahlgren
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28. Rehabilitation: the chronic phase
- Prof. Lalit Kalra
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29. Prevention: management of risk and protective factors
- Prof. Graeme Hankey
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30. Medical therapy for secondary prevention of ischemic stroke
- Prof. Larry Goldstein
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31. Subarachnoid haemorrhage
- Prof. Jan van Gijn
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32. Controversies in stroke
- Prof. Stephen Davies
- Prof. Geoffrey Donnan
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33. Medical and surgical stroke
- Prof. Carlos Kase
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34. The urgency of stroke prevention after TIA
- Prof. S. Claiborne Johnston
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35. Carotid endarterectomy, angioplasty and stenting
- Prof. Martin Brown
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36. The clinical diagnosis of stroke and stroke subtypes
- Prof. Louis Caplan
Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Learning objectives
- Strokes can happen at any age
- Diffusion MRIs of young stroke patients
- “Pressing issues and promising directions”
- Example: 9-year-old
- Acute intervention in ischemic stroke
- Thrombolysis in Pediatric Stroke
- The ESCAPE trial
- Protocol for children presenting with acute stroke
- Stroke treatment timeline
- Neuroprotection
- Neuroprotection: 5-year-old
- Guidelines for childhood stroke
- Example: 5-year-old with stroke
- Steroids in acute Focal Cerebral Arteriopathy (FCA)
- Example of child that developed malignant cerebral edema
- Malignant cerebral edema
- Epidemiology of AIS
- Clinical presentation of AIS
- Pediatric AIS: Etiology and risk factors
- Arteriopathy is the main cause of stroke
- Childhood cerebral arteriopathies
- The VIPS study
- Example: 15-year-old
- Arterial tortuosity as an imaging biomarker
- Sickle-cell disease: primary and secondary prevention
- Example: 9-year-old
- Example: brother and sister
- Moyamoya disease
- Example: 5-year-old with dwarfism
- Fibromuscular dysplasia in children
- ADA2 can cause recurrent small strokes in children
- Example: 12-year-old
- Cerebral sinovenous thrombosis (CSVT) in children
- Pediatric CSVT: Diagnosis
- Thrombophilias are associated with childhood CSVT
- Anticoagulants in pediatric CSVT
- Pediatric CSVT: treatment
- Pediatric CSVT example: 15-year-old
- Example: 13-year-old
- Hemorrhagic stroke: epidemiology
- Hemorrhagic stroke: clinical presentation
- Hemorrhagic stroke: etiology
- Hemorrhagic stroke: investigation
- Example: 15-year-old
- Example: 14-year-old
- Cerebral Cavernous Malformations (CCM)
- Hereditary hemorrhagic telangiectasia (HHT)
- Strokes can happen at any age
- Perinatal stroke syndromes (1)
- Perinatal stroke syndromes (2)
- Perinatal stroke
- Alberta Perinatal Stroke Project (APSP)
- What causes perinatal stroke? Possible risk factors
- Placenta as a top risk factor
- Acute inflammatory profiles of perinatal stroke
- Neuroprotection
- Neuroprotection: erythropoietin
- Example: 6-day-old term neonate (1)
- Example: 6-day-old term neonate (2)
- CSVT visualization
- Anticoagulants in pediatric CSVT
- Example: 8-day-old neonate
- Example: brain hemorrhage in a neonate
- Neonatal hemorrhagic stroke research
- Example: 1-day-old neonate with seizures on day 1
- Perinatal stroke syndromes
- Periventricular Venous Infarction (PVI)
- Learning objectives
- Perinatal stroke outcomes
- Outcomes in childhood AIS
- Stroke outcomes can be modulated throughout development
- Motor recovery after stroke
- Robotic TMS mapping of motor cortex
- Perinatal stroke plasticity imaging
- From imaging to neuromodulation
- The PLASTIC CHAMPS trial
- Transcranial direct-current stimulation can enhance motor learning in children
- Accelerated Motor Learning in PEDiatrics (AMPED)
- Phase II trial in children with perinatal stroke and hemiparesis
- SPORT trial
- Different goals for different patients
- Example: 14-year-old footballer (1)
- Example: 14-year-old footballer (2)
- Example of developmental plasticity
- Measuring patterns of language reorganization
- Education and mental health
- Parent education
- Community support groups
- Success stories
- Acknowledgements
- www.perinatalstroke.ca
Topics Covered
- Stroke in neonates and children
- Arterial ischemic stroke
- Cerebral sinovenous thrombosis
- Hemorrhagic stroke
- Acute diagnosis and management of childhood stroke
- Etiology and investigation of childhood stroke
- Treatment and prevention in childhood stroke
- Diagnosis and types of perinatal stroke
- Pathogenesis of perinatal stroke
- Outcomes from perinatal and childhood stroke
- Imaging applications for diagnosis and developmental plasticity
- Rehabilitation strategies
- Patient and family centered outcomes & supportive management
Links
Series:
Categories:
Therapeutic Areas:
External Links
- Protocol for children presenting with acute stroke (1)
- Protocol for children presenting with acute stroke (2)
- Protocol for children presenting with acute stroke (3)
- Key recommendations for childhood stroke
- The diagnosis and acute management of childhood stroke
- Antithrombotic therapy in neonates and children
- Management of stroke in infants and children
- New efforts to stimulate a damaged brain at the Alberta Children’s Hospital show great results
Talk Citation
Kirton, A. (2020, April 30). Pediatric stroke: cerebrovascular injury in the developing brain [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 10, 2024, from https://doi.org/10.69645/OZVF2240.Export Citation (RIS)
Publication History
Financial Disclosures
- There are no commercial/financial matters to disclose.
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Adam Kirton.
I'm a pediatric neurologist in Calgary, Canada,
and I'm a Professor of Pediatrics,
Radiology, and Clinical Neuroscience.
I have a special interest in stroke in children,
and that's what I'm going to speak about today.
I'd like to thank the organizers for inviting me to give this talk and look forward
to teaching you something about the youngest stroke patients,
what's unique about them,
and sometimes the amazing things they can do.
I'll give you many examples of many bad outcomes,
but also a lot of good outcomes that I hope you find inspiring.
0:37
I don't have any particular disclosures other than sitting on
some scientific advisory boards and receiving
research grants from the agencies listed below.
I'm also the editor of a textbook on brain stimulation.
0:49
The primary learning objectives for today are to give you a general overview,
first of the clinical side of how strokes present in young patients,
and by that I mean everything from the fetus and newborn through to teenagers.
I'll go over the different types of stroke,
how they present, the underlying causes and risk factors, and how these are managed.
The second objective, that is somewhat more specific to
young stroke patients, is to comment on recovery and outcomes, and in particular,
how well young stroke patients can sometimes do and how that relates to
the plasticity of the developing brain that
may be a bit different from that seen in adults.
1:30
Stroke really can happen at any age.
Most people think of old people when they hear the word stroke.
But a stroke in the fetus, newborn,
and in children is a relatively common problem in my field of child neurology.
Perinatal stroke affects up to 10,000 children just in Canada,
that's a population of about 35 million people.
The incidence of stroke later in childhood is actually more common than brain tumors,
so these are real neurological problems.
While they are relatively small percentage of all stroke seen in the world,
they have unique elements that I'll try to highlight to you today,
that I think teaches us a lot about stroke as a disease in general.