Pediatric_Stroke_Presentation.presentation

This summarised version of stroke in pediatric patients

1. Pediatric Stroke Pathophysiology, Diagnosis & Management Bairavi Ravindiran Tbilisi State Medical University Child Neurology Presentation

2. Introduction / Definition & Scope Definition of pediatric stroke Perinatal/neonatal vs. childhood/adolescent stroke Unique features compared to adults

3. Epidemiology & Classification Incidence & prevalence Ischemic vs hemorrhagic vs venous stroke Perinatal classification subtypes

4. Pathophysiology & Mechanisms Ischemia, excitotoxicity, reperfusion injury Developmental vulnerabilities Hemorrhagic & venous mechanisms

5. Etiologies & Risk Factors Arteriopathies: FCA, Moyamoya, dissection Cardioembolic causes Prothrombotic disorders Infections & inflammatory Perinatal factors

6. Clinical Presentation & Age-specific Features Neonates: seizures, apnea, feeding difficulty Children: sudden hemiparesis, aphasia, headache Adolescents: stroke-like adult presentation

7. Differential Diagnosis & Pitfalls Mimics: migraine, Todd’s paralysis, ADEM, tumor Metabolic stroke syndromes Common diagnostic delays & pitfalls

8. Diagnostic Workup / Imaging & Labs CT/MRI (DWI gold standard) MRA/MRV, Doppler Lab tests: coagulation, metabolic, infectious Cardiac evaluation

9. Acute Management Stabilization: airway, oxygen, glucose Thrombolysis: tPA (selected cases) Mechanical thrombectomy (older children) Seizure & ICP control

10. Subacute & Long-term Management Rehabilitation: PT, OT, speech Antithrombotic therapy Treat underlying causes Neuropsychological support

11. Outcomes & Prognosis Mortality: 3–6% ~60% survivors with permanent deficits Sequelae: hemiparesis, epilepsy, cognitive issues Prognostic factors

12. Challenges & Recent Advances Limited trials in children Diagnostic delays Advances: thrombectomy, imaging, registries Research gaps: biomarkers, protocols

13. Case Vignette & Key Learning Points Example case with acute MCA stroke Diagnosis, management, outcome Key lessons: - High suspicion required - Early imaging critical - Rehabilitation essential

14. Thank You Questions & Discussion