Pediatric Neurovascular Emergencies

Stroke is a leading cause of childhood mortality. Moreover, stroke survivors are at risk of persistent neurological deficits, seizures, and stroke recurrence. Venous thromboembolism most commonly refers to deep vein thrombosis and pulmonary embolism, although it can occur anywhere in the vascular system, including the renal and portal circulation systems. Hypertensive emergency is defined as acute severe hypertension with target organ damage or life-threatening features. Pediatric stroke, venous thromboembolism, and hypertensive emergencies occur less frequently in children than in adults. The underlying pathophysiology is significantly different in children. Despite differences between children and adults in risk factors and contributing factors, treatment is often extrapolated from adult management. This chapter reviews common and atypical presentations of these disorders, the approach to diagnostic confirmation, as well as important management principles.