Affiliations: Carman and Ann Adams Department of Pediatrics, Wayne
State University, School of Medicine, Detroit, MI, USA | Department of Neurology, Wayne State University,
School of Medicine, Detroit, MI, USA | Department of Radiology, Wayne State University,
School of Medicine, Detroit, MI, USA
Note: [] Correspondence: Dr. Lalitha Sivaswamy, MD, Children's Hospital
of Michigan, Neurology, 3901 Beaubien Blvd., Detroit, MI 48201, USA. Tel.: +1
313 745 5788; Fax: +1 313 745 0955; E-mail: lsivaswamy@med.wayne.edu
Abstract: Multiple modalities for imaging of pediatric stroke are available,
though not all have clinical application in acute stage. In this article, we
review the relative advantages and disadvantages of imaging methods designed to
visualize the brain parenchyma, arteries, veins as well as the penumbra in
arterial and venous ischemic events of childhood and perinatal strokes. The
applications of diffusion-weighted magnetic resonance imaging (MRI) in the
setting of neonatal stroke have led to a better understanding of the extent of
damage in a relatively early stage, which helped to overcome certain
limitations of cranial ultrasound. Comparative analysis between MRI including
T2* gradient echo images, and computed tomography in
hemorrhagic stroke has changed the commonly held belief that cranial computed
tomography is superior to MRI in this clinical scenario. Susceptibility
perfusion MRI and arterial spin labeling methods have been applied successfully
in adult strokes; however, their introduction into the pediatric realm has been
limited. Finally, the employment of diffusion tensor imaging, magnetic
resonance spectroscopy and positron emission tomography technologies have been
shown to be useful in predicting the extent of recovery from stroke.
