Pediatric emergency medicine trisk 2632 2632
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unfractionated heparin. The choice of acute anticoagulation treatment as well as
long-term preventative therapy is influenced by stroke etiology as well as the
presence of a cardioembolic cause or arterial dissection.
Further therapy is determined by the type of stroke. Neurosurgical intervention
may be required to evacuate a hematoma or control a bleeding arteriovenous
malformation (AVM). Catheter-directed embolization may also be possible in
cases of AVM. Children with sickle cell disease and stroke should have acute
transfusion to decrease the level of hemoglobin S to less than 30%. Novel
therapies such as calcium channel blockers and free radical scavengers have not
been studied in pediatric patients and their use remains experimental.
Regardless of treatment, long-term morbidity of stroke in children is high, with
more than 75% of affected children experiencing sequelae such as hemiparesis,
seizures, and learning difficulties. Overall, prognosis for children with stroke is
better than that in adults.
