Cerebrovascular disease in children and young adults accounts for 5% to 10% of all stroke cases and remains one of the top ten causes of childhood death, encompassing a broad range of causes and risk factors. This often represents a diagnostic and therapeutic challenge to clinicians with an average recognition time of 35.7 hours for the younger patients. Considerable progress has been made in our understanding of the incidence, etiology, diagnosis, and treatment of stroke in children and young adults. Even with this progress, however, clinicians, parents, patients, and caregivers can sometimes become disappointed or frustrated because the cause of the disease may remain undetermined in a considerable percentage of patients and a uniform approach to treatment is often lacking. Cerebrovascular disease occurring in this age category spans multiple medical specialties. Clinicians caring for young stroke victims are becoming increasingly familiar with the catastrophic consequences of these disorders which include not only a dramatic decline in the quality of life among survivors but potential socioeconomic consequences as well.
This edition serves to provide an updated and more expansive resource that will be instrumental to clinical practices focusing on cerebrovascular disease in young people. It continues to address the practical needs of house officers, neurologists, and neurosurgeons as well as the needs of specialists in the fields of pediatrics, internal medicine, family practice, emergency medicine, nursing and other allied health professionals who care for a wide variety of young patients with ischemic and hemorrhagic cerebrovascular disease.
Just as in the First Edition, the book begins with an overview of stroke types, risk factors, prognosis, and diagnostic strategies in neonates, children and young adults. This is followed by a new, highly detailed and thoroughly illustrated chapter on the applied anatomy of brain arteries, which is presented in order to familiarize the reader with the relevant neuroanatomical correlation of symptoms and signs pertaining to important stroke syndromes. Chapters 3 and 4 contain an expanded discussion on the epidemiology, clinical presentation, evaluation, and treatments of stroke during the first 18 years of life and the individualized approach to neonates, children and young adults. The next three chapters provide a detailed discussion on atherosclerotic cerebral infarction, non-atherosclerotic vasculopathies, and cardiac disorders and strokes occurring in children and young adults. There are separate and fully updated chapters pertaining to cerebral infarction and migraines, as well as hemostatic disorders presenting as stroke. Since pregnancy-associated stroke remains a major cause of serious morbidity and mortality, a comprehensive review of pregnancy associated ischemic and hemorrhagic strokes is discussed independently. Similarly, as rare genetic disorders can lead to stroke, and diagnosis of these inherited conditions have important implications for the patient regarding stroke and his family, a concise review of rare genetic disorders that are associated with stroke is contained in Chapter 11. Cerebral venousthrombosis represents less than 1% to 2% of all stroke cases and although patients often present later in the course of their disease, it is more easily diagnosed with the advent of modern neuroimaging. Chapter 12 covers the epidemiology, clinical presentation, diagnosis, and management of thrombosis of the cerebral veins and sinuses along with the various etiologies which contribute to its development. Subsequent chapters contain further insights into neonatal intracranial hemorrhage (a significant problem in neonatal intensive care units), spontaneous intracerebral hemorrhage (which accounts for about 15% of all strokes), and subarachnoid hemorrhage in young adults. Finally, there are two new chapters—one of which focuses on pediatric central nervous system (CNS) vascular malformations (a common cause of non-traumatic intracerebral hemorrhage in this age group), and the other on the various types of spinal cord vascular malformations in children and young adults.
We hope the readers of Stroke in Children and Young Adults, Second Edition, will find it to be current and clinically beneficial. In addition, we hope that the knowledge about the disorders covered in this book will be utilized to benefit the patients who have helped us increase our understanding of stroke within this age group.
Key Features
- Includes an overview of stroke types, risk factors, prognosis, and diagnostic strategies in neonates, children, and young adults to help you better manage every condition you see.
- Discusses the diverse etiologies of stroke in children and young adults to increase awareness in the differences of presenting signs between children and adults.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
Contents
Chapter 1 - Stroke in Children and Young Adults: Overview, Risk Factors, and Prognosis
- Stroke Incidence
- Stroke Presentation in Young Individuals
- Stroke Causes
- Risk Factors for Ischemic Stroke in Young Individuals
- Stroke of Uncertain Etiology
- Cerebral Sinovenous Thrombosis
- Brain Hemorrhage
- Risk of Stroke Recurrence
- Prognosis
- Conclusion
- References
Chapter 2 - Applied Anatomy of the Brain Arteries
- Four Major Arteries to the Brain and Formation of the Circle of Willis
- Internal Carotid Arteries
- Anterior Cerebral Artery
- Middle Cerebral Artery
- Posterior Cerebral Artery
- Basal Forebrain Arteries
- Medial Striate Arteries
- Origin and Distribution of the Recurrent Artery of Heubner (Artery Centralis Media)
- Lateral Striate (Lenticulostriate) Arteries
- Anterior Choroidal Arteries
- Thalamic Arteries
- Thalamotuberal Artery (= Thalamic Polar Artery = Premammillary Artery = Anterior Thalamosubthalamic Paramedian Artery = Anterior Thalamoperforating Artery)
- Thalamogeniculate Artery
- Paramedian Posterior Thalamoperforant Arteries (= Superior Paramedian Branches of Basilar Communicating Artery = Paramedian Peduncular Artery = Postmammillary Artery)
- Medial Posterior Choroidal Artery
- Lateral Posterior Choroidal Artery
- Rostral Basilar Artery Syndrome (Top of the Basilar Syndrome)
- Summary of the Distribution of the Arteries of the Basal Forebrain and Deep Gray Matter
- Vertebrobasilar Arteries
- Midbrain: Syndromes of Basilar Artery and Posterior Cerebral Artery Occlusion
- Pons: Syndromes of Basilar Artery Occlusion
- Arteries of the Cerebellum and Medulla Oblongata
- Superior Cerebellar Artery
- Anterior Inferior Cerebellar Artery
- Internal Auditory Artery
- Posterior Inferior Cerebellar Artery
- Median-Paramedian Arteries of the Medulla and the Medial Medullary Syndromes of Dejerine, Babinski-Nageotte, and Opalski
Chapter 3 - Stroke in Neonates and Children: Overview
- Epidemiology
- Clinical Presentation
- Causes
- Evaluation
- Treatment
- Conclusion
Chapter 4 - Diagnostic Strategies in Neonates, Children, and Young Adults with Stroke
- Clinical Presentation
- History and Physical Examination in Young Patients with Stroke
- Neuroimaging
- Laboratory Examination
- Pathology
- Miscellaneous Evaluations
- Conclusion
Chapter 5 - Atherosclerotic Cerebral Infarction in Young Adults
- Pathogenesis
- Risk Factors
- Clinical Features
- Paraclinical Evaluation
- Management
Chapter 6 - Nonatherosclerotic Cerebral Vasculopathies
- Hypoplasia and Agenesis of the Internal Carotid Artery
- Moyamoya Disease
- Fibromuscular Dysplasia
- Cervicocephalic Arterial Dissections
- Radiation-induced Vasculopathies
- Central Nervous System Vasculitides
- Conclusion
Chapter 7 - Cardiac Disorders and Stroke in Children and Young Adults
- Clinical Features
- Causes
- Conclusion
Chapter 8 - Cerebral Infarction and Migraine
- Diagnostic Criteria for Migrainous Infarction
- Epidemiology of Migrainous Infarction
- Clinical Picture
- Pathophysiology
- Migraine and White Matter Disease
- Investigation of a Patient with a Migraine-Associated Cerebral Infarction
- Management of Migraine-Induced Infarctions
- Conclusion
Chapter 9 - Hemostatic Disorders Presenting as Cerebral Infarction
- Primary Hypercoagulable States
- Heparin Cofactor II Deficiency
- Secondary Hypercoagulable States
- Conclusion
Chapter 10 - Stroke and Pregnancy
- Epidemiology
- Ischemic Stroke
- Hemorrhagic Stroke
- Conclusion
Chapter 11 - Rare Genetic Disorders Predisposing to Stroke
- Inherited Disorders Causing Accelerated Atherosclerosis
- Inherited Nonatherosclerotic Vasculopathies
- Inherited Hematologic Abnormalities
- Inherited Cardiac Disorders
- Inherited Metabolic Disorders
- Conclusion
Chapter 12 - Cerebral Venous Thrombosis
- Incidence
- Anatomy of the Cerebral Sinovenous System
- Clinical Presentation
- Clinical Presentations in Neonates and Infants
- Predisposing Conditions
- Diagnostic Procedures
- Management
- Prognosis
- Conclusion
Chapter 13 - Neonatal Intracranial Hemorrhage
- Etiology
- Cerebrospinal Fluid Findings
- Extracranial Hemorrhages
- Subdural Hemorrhage
- Primary Subarachnoid Hemorrhage
- Intracerebral Hemorrhage and Cerebellar Hemorrhage
- Intraventricular Hemorrhage in a Term Neonate
- Germinal Matrix Intraventricular Hemorrhage in a Premature Infant
- Conclusion
Chapter 14 - Spontaneous Intracerebral Hemorrhage
- Epidemiology
- Etiology
- Clinical Features
- Paraclinical Evaluation
- Treatment
- Conclusion
Chapter 15 - Subarachnoid Hemorrhage in Young Adults
- Etiology, Epidemiology, and Risk Factor Modification
- Diagnosis
- Management of Aneurysmal Subarachnoid Hemorrhage
- Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage
- Conclusion
Chapter 16 - Pediatric Central Nervous System Vascular Malformations
- Arteriovenous Malformations
- Vein of Galen Malformations
- Cavernous Malformations
- Venous Angiomas
- Capillary Telangiectasias
- Conclusion
Chapter 17 - Vascular Disorders of the Spinal Cord in Children and Young Adults
- Classification
- Pathophysiology of Injury from Vascular Malformations
- Arteriovenous Malformations
- Perimedullary Arteriovenous Fistula
- Cavernous Malformations
- Complex Vascular Malformations
About the Author
- José Biller, MD, FACP, FAAN, FAHA, Professor and Chairman, Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois.
Book Review
Professor Biller and his colleagues responded to this challenge and extensively revised and added to the material originally published bringing this document up to date and including information published in the early part of 2008. This has resulted in extensive rewriting of the original 14 chapters and the addition of three new chapters. This is indeed a state-of-the-art publication. For example, most of the references are published after 1994. As one reviews the galleys, one is struck by how much has been added to our knowledge during this time. In addition to many of the original contributors, others have been added and have continued the high quality of work produced in the first edition.
The additional three chapters extend and add information to that included in the first edition. In particular, the chapter, Applied Anatomy of the Brain Arteries, by William DeMyer should serve as an invaluable addition for any understanding of vascular supply and clinical syndromes related to the brain arteries and for a reference in the future. It is unlikely that someone not working primarily in stroke would keep all of these details constantly in mind. As this book was in the final editing process, Dr. DeMyer died at the age of 84 years. Although physically incapacitated during his final few months, hecontinued to work and contribute in many areas of Neurology and completed his final book, Taking the Clinical History: Eliciting Symptoms, Ethical Foundations, a few days before his death. The dedication of this book to him, expresses the high regard that Biller, his colleagues, and all who know of his many contributions and his work ethic have for him. It is also a reflection of Professor Biller's good judgment in selecting outstanding contributors for inclusion in this volume.
Let us hope that the continued rapid acquisition of knowledge makes it necessary for a third edition long before 14 years. In the meantime, this updated volume will serve as the state-of-the-art source for understanding of Stroke in Children and Young Adults.
-- By Mark L. Dyken, M.D., Professor Emeritus of Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana.
Product Details
- Hardcover: 368 pages
- Publisher: Saunders; 2 edition (March 9, 2009)
- Language: English
- ISBN-10: 0750674180
- ISBN-13: 978-0750674188
- Product Dimensions: 10.5 x 7.4 x 0.9 inches
List Price: $142.00