Summary
The past decade has seen a dramatic increase in pediatric stroke research. However
few studies have addressed anti-thrombotic safety or effectiveness. Three paediatric
stroke guidelines combining research data with expert consensus have been published
in the past five years. For most patients treatment recommendations are consistent.
Newborns with arterial ischaemic stroke (AIS) rarely require antithrombotic treatment
given their extremely low risk of recurrence. In children with AIS a substantial recurrence
risk means that antithrombotic treatment is required unless contraindicated. Anticoagulation
(heparins, warfarin) is recommended for possible or established dissection and cardiogenic
embolism. Antiplatelet treatment is recommended for other children with AIS. For neonatal
cerebral sinovenous thrombosis (CSVT) most centers provide initial anticoagulation
in the absence of haemorrhagic contra indications, and otherwise, monitor for propagation.
Children with CSVT, even with haemorrhagic infarction, more consistently receive anticoagulation,
as in adults. While more studies are necessary, current treatment guidelines offer
an interim option for guiding the treatment of paediatric stroke.
Keywords
Paediatric stroke - antithrombotic treatment
