Specificities of arterial ischemic stroke in childhood.

Despite the number of potential causes, most children with ischemic cerebro vascular disease are classified into a few major categories: 1) cardioembol ic stroke; 2) moyamoya syndrome; 3) complication(s) connected with systemic disease, with a known risk of a cerebrovascular event; 4) cervicocephalic arterial dissection; and 5) transient cerebral arteriopathy of undefined or igin (probable arteritis). The etiological diagnosis is rapidly established by complementary investigations based on the initial clinical and imaging findings: cardiac exploration, magnetic resonance imaging and angiography o r echo-doppler of the cervical arteries if cervical dissection is suspected ; intra-arterial catheter cerebral angiography and analysis of the cerebros pinal fluid to investigate an intracranial arteriopathy. The outcome and tr eatment depend on the type of stroke, on its accurate identification, and o n prediction regarding the risk of recurrence. Although there is a constitu tional predisposition to cerebrovascular accidents, environmental triggers such as trauma, infectious disease and cardiac surgery also play a major ro le. (C) 2001 Editions scientifiques et medicales Elsevier SAS.