Conventional cerebral angiography in children with ischemic stroke

A retrospective review of conventional cerebral angiograms of 46 children w ith ischemic stroke was undertaken. Comparison was made with findings on ma gnetic resonance imaging and magnetic resonance angiography where available . Thirty-six children (78%) underwent magnetic resonance angiography in add ition to conventional cerebral angiography, Seven patients had normal cereb ral angiograms. Magnetic resonance angiography was diagnostic in 25 of 28 p atients with large vessel occlusion, stenosis, or moyamoya syndrome. Conven tional angiography was abnormal in four of nine patients with a normal magn etic resonance angiography. All patients with normal conventional angiogram s also had normal magnetic resonance angiograms. Conventional angiography, either diagnostic or yielding further information, altered management in fi ve patients with arterial dissection, one patient,vith large vessel occlusi on, one patient with large vessel stenosis, and four patients with arteriti s, On the basis of this experience, a clinical algorithm for the use of con ventional cerebral angiography in the investigation of ischemic stroke in c hildren is proposed. (C) 1999 by Elsevier Science Inc. All rights reserved.