Pediatric Stroke and Cerebrovascular Program

Overview

The Pediatric Stroke and Cerebrovascular Program 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 and rehabilitation. We also coordinate with the Mass General Fireman Vascular Center, Young Adult Stroke Program and Comprehensive Stroke Center to provide continuity thorughout our patients' lives.

We have expertise in:

• Acute stroke management in older children and adolescents
• Strokes in newborns and infants
• Neurocritical care
• Brain imaging evaluation of stroke and cervico-cranial vascular disorders
• Consultations for arterial dissections, vasculitis, Moyamoya 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 Mass General 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.

Research

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). If you and your child would like to participate in clinical research to advance stroke care, please speak with your doctor.