Explore This Treatment Program

Overview

The Pediatric Stroke and Vascular Service cares for premature infants, children or adolescents who have had a stroke, whether ischemic or hemorrhagic, or who have had cerebral venous sinus thrombosis. The service is a specialized team comprising a stroke neurologist, a pediatric hematologist, a pediatric general neurologist, pediatric neuroradiologists, pediatric intensivists, neurosurgeons, a laboratory coagulation specialist and a stroke nurse. Our team provides continuity of care, following a patient from admission to the Neonatal Intensive Care Unit or Pediatric Intensive Care Unit to discharge.

We have expertise in:

  • Acute stroke management in older children and adolescents
  • Strokes in neonates and infants
  • Neurocritical care
  • Brain imaging evaluation of stroke and cervico-cranial vascular disorders
  • Consultations for arterial dissections, vasculitis, Moya-moya disease, coagulation and hematological disorders, congenital or genetic causes of stroke, cavernous or arteriovenous malformations (AVM), aneurysms, cardiogenic sources of embolism and acute intra-arterial thrombolysis management
  • Counseling families of children with thrombophilia or with a family history of stroke
  • Evaluation and management of post-stroke seizures

Counseling relatively healthy young people who have one or more close relatives with stroke about their risk of stroke is an important part of what we do. This risk assessment extends to congenital thrombophilia, vascular factors and possible interventions or medications to minimize risk. In addition, we offer evaluations for other cerebrovascular disorders, such as arterial dissections, aneurysms and arteriovenous malformations.

The Pediatric Stroke and Vascular Service at MassGeneral Hospital for Children is one of the oldest and largest in North America. Among the more frequent diagnoses that we see are acute ischemic stroke and vascular disorders masquerading as possible stroke. A very special role is the assessment and management of stroke risk in young children and adolescents whose parents and close relatives have suffered stroke(s) in young adulthood.

Members of the Pediatric Stroke and Vascular Service are currently evaluating the role of plasma phase risk factors in pediatric stroke, including lipoprotein (a). We are also interested in the possible predictive role of circulating tissue factor-positive microparticles. Our team participates in the International Pediatric Stroke Study (IPSS).

Newly Diagnosed

You have just been told your child suffered a stroke. First of all, you are not alone! There is a lot you can do to help your child.

If your child has recently received a diagnosis of stroke you’re probably experiencing a variety of emotions and you probably have hundreds of questions about the condition, the prognosis, and available treatments. The Pediatric Stroke and Vascular Service is here to help your child, to offer hope, and to provide information and resources that may be useful to you and your child in this journey

What Do I Do next?

Newborns

If your newborn has been diagnosed with stroke close monitoring, control of seizures and evaluations are necessary to prevent further injury to the brain and optimize the changes of his/her neurological development and recovery. It is very important that your baby is evaluated by a Pediatric/Perinatal Stroke Team as soon as possible. You can request to speak with the specialist in the hospital you are at, request a transfer to a hospital with pediatric stroke services like Mass General or contact us anytime at 617-726-2000 (paging Child Neurology on-call physician).

Infants and Children

All patients with symptoms of stroke, regardless of age, need to be assessed immediately by health-care professionals.

Urgent concerns

Infants with early hand preference before 18 months should see their family doctor or pediatrician and request a referral to pediatric neurologist. Your primary care physician can request a consultation with the Pediatric Stroke and Vascular Service at 617-643-0241.

Strokes can happen at any age (PDF) | Los ataques cerebrales pueden ocurrir a cualquier edad (PDF)

About This Program

Children with stroke often see a number of health care professionals. Each child is different and may be required to see a number of specialists. However, some children may only be followed by a pediatrician, stroke team and physical therapist, while other children may see additional specialists, depending on their needs.

On arrival, please check in at the front desk of Yawkey 8B (Pediatric Hematology). Typically, sixty minutes are scheduled for your first appointment and thirty minutes are allotted for follow-up appointments. However, due to the complexity of this visit, it is not uncommon to be in the clinic for up to two hours. If laboratory tests are indicated, you may choose to have them done during your visit to our clinic. At the end of your appointment, you will be able to schedule a follow-up appointment, if necessary.

Typical Evaluation at the Pediatric Stroke Clinic

Physicians who work in the Multidisciplinary Pediatric Stroke Clinic offer comprehensive patient evaluations. You may see up to three doctors during your appointment; however, they may see you and your child sequentially or as a group. In either case, you will be able to remain in one exam room for the entire appointment.

A member of the team will begin by reviewing your current concerns and your child’s symptoms. Following this the doctor will ask you about your child’s medical and neurologic history, family health history, and his/her social history. The physician will also ask about your child’s development.

Following this detailed history, the physician will perform a physical exam. The physical exam will include, in addition to a focused general exam a detailed neurological examination.

Once the physical evaluation is complete, the physician team will review their findings with you. Together you will discuss possible further testing and/or a treatment plan. Our staff, at the front desk, will assist you with setting up future testing, if needed. Please note that no formal neuropsychological testing will be performed during your exam in the neurology clinic.