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Issue: Issue 4 (2017) – Supplement 1


Hemorrhagic stroke in children: expect the unexpectable

Catarina Perry da Câmara, Marcos Veiga, Carolina Pinheiro, Teresa Morais, João Jacinto, Isabel Fragata, Carla Conceição, and João Reis
Background: Pediatric stroke is unexpectedly common, with an incidence in children between 28 days old and 18 years old of 2.3 to 13 per 100,000/year. Contrary to the 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 such 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.

From the Lisbon Stroke Summit, Lisbon, Portugal. 7–8 April 2017.

International Journal of Clinical Neurosciences and Mental Health 2017; 4(Suppl. 1):P12
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