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2023

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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HEMORRHAGIC STROKE IN CHILDREN: EXPECT THE UNEXPECTABLE

Perry da Câmara, Catarina; Veiga, Marcos: Pinheiro, Carolina; Morais, Teresa; Jacinto, João; Fragata. Isabel; Conceição, Carla; Reis, João.

Neuroradiology Department, Hospital Dona Estefânia e Hospital São José, Centro Hospitalar Lisboa Central

- Lisbon Stroke Summit, 7 a 8 de abril de 2017

Background: Pediatric stroke is unexpectedly common, with an incidence in children between 28 days and 18 years old of 2.3 to 13 per 100,000/year. Contrary to adult population, in children 45% of strokes are hemorrhagic and the most common cause is vascular anomalies. Albeit the incidence, median time to diagnosis is about 23 hours, impairing the prognosis.
Objectives: This work aims to alert the medical community about hemorrhagic stroke in children.
Methods: A review of our Neuroradiology database was performed for hemorrhagic stroke in children. Best imaging examples were selected.
Results: We present a pictorial review of different presentations and etiologies of hemorrhagic stroke on CT, MRI and angiography. A systematic imaging approach to diagnosis was performed. Cases to be shown include: arteriovenous malformations, aneurysms, cavernous malformations, sickle cell disease and coagulopathies as: leukemia, anticoagulation treatment or hemophilia. In addition to this review, we also put in perspective the delay in diagnosis, opening discussion to what needs to be done to prevent it.
Conclusion: Hemorrhagic stroke is an important cause of morbidity in children. Doctors’ awareness and rapid neuroimaging are essential to a prompt diagnosis.

Palavras Chave: Hemorrhagic stroke; Imaging; Pediatric stroke;