“Classification of Stroke” by Miya Bernson-Leung for OPENPediatrics

“Classification of Stroke” by Miya Bernson-Leung for OPENPediatrics


Classification of Stroke, by Dr. Miya Bernson-Leung. Stroke can be divided into ischemic and hemorrhagic. And in children, about half of strokes are
ischemic, and half are hemorrhagic. An ischemic stroke occurs when brain tissue
is damaged due to the blockage of an artery or vein. An arterial ischemic stroke, or AIS, is caused
by the loss of downstream blood supply when an artery is occluded. This can be resulting from areas of vessel
lumen narrowing or endothelial injury, an increase in clot formation, what we call hypercoagulability,
or thromboembolism, when a clot formed elsewhere in the body, such as in the heart, moves and
becomes lodged in a cerebral artery. Ischemic stroke resulting from the blockage
of a vein is called “venous infarction.” The loss of venous drainage leads to pressure
buildup and therefore tissue damage. This is one possible result of a cerebral
sinovenous thrombosis, or CSVT, when a clot forms within the draining sinuses of the brain. Transient ischemic attack, or TIA, is defined
as the symptoms of an ischemic stroke that resolve. In adults, this has been defined as symptom
resolution within 24 hours without ischemic injury being apparent on imaging. And we now know that TIA can also occur in
children. TIA is important because it often heralds
a future stroke. And therefore, a complete workup is warranted. Hemorrhagic strokes occur when there is tissue
damage due to bleeding within the brain, an intraparenchymal hemorrhage, or adjacent to
the surface of the brain, a subarachnoid hemorrhage. This produces mass effect and ischemia of
the adjacent tissues.

One thought on ““Classification of Stroke” by Miya Bernson-Leung for OPENPediatrics

Leave a Reply

Your email address will not be published. Required fields are marked *