Imaging of Suspected Stroke in Children, From the AJR Special Series on Emergency Radiology

AJR Am J Roentgenol. 2023 Mar;220(3):330-342. doi: 10.2214/AJR.22.27816. Epub 2022 Aug 31.

Abstract

Pediatric stroke encompasses different causes, clinical presentations, and associated conditions across ages. Although it is relatively uncommon, pediatric stroke presents with poor short- and long-term outcomes in many cases. Because of a wide range of overlapping presenting symptoms between pediatric stroke and other more common conditions, such as migraine and seizures, stroke diagnosis can be challenging or delayed in children. When combined with a comprehensive medical history and physical examination, neuroimaging plays a crucial role in diagnosing stroke and differentiating stroke mimics. This review highlights the current neuroimaging workup for diagnosing pediatric stroke in the emergency department, describes advantages and disadvantages of different imaging modalities, highlights disorders that predispose children to infarct or hemorrhage, and presents an overview of stroke mimics. Key differences in the initial approach to suspected stroke between children and adults are also discussed.

Keywords: cerebrovascular disease; neuroimaging; pediatric imaging; stroke; stroke mimic.

Publication types

  • Review

MeSH terms

  • Adult
  • Child
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Humans
  • Migraine Disorders* / complications
  • Migraine Disorders* / diagnosis
  • Radiology*
  • Seizures
  • Stroke* / etiology