​Symptoms and Signs – Differential Diagnosis of Stroke, Pediatric Age
CARDIAC DISEASE
• Congenital: aortic stenosis, mitral stenosis, mitral prolapse, ventricular septal defects, patent ductus arteriosus, cyanotic congenital heart disease involving right-to-left shunt
• Acquired: endocarditis (bacterial, systemic lupus erythematosus [SLE]), Kawasaki’s disease, cardiomyopathy, atrial myxoma, arrhythmia, paradoxical emboli through patent foramen ovale, rheumatic fever, prosthetic heart valve
HEMATOLOGIC ABNORMALITIES
• Hemoglobinopathies: sickle cell disease
• Polycythemia
• Leukemia/lymphoma
• Thrombocytopenia
• Thrombocytosis
• Disorders of coagulation: protein C deficiency, protein S deficiency, factor V Leiden, antithrombin III deficiency, lupus anticoagulant, oral contraceptive pill use, pregnancy and the postpartum state, disseminated intravascular coagulation (DIC), paroxysmal nocturnal hemoglobinuria, inflammatory bowel disease (IBD) (thrombosis)
INFLAMMATORY DISORDERS
• Meningitis: viral, bacterial, tuberculosis
• Systemic infection: viremia, bacteremia, local head and neck
infections
• Drug-induced inflammation: amphetamine, cocaine
AUTOIMMUNE DISEASE
• SLE
• Juvenile rheumatoid arthritis (JRA)
• Takayasu’s arteritis
• Mixed connective tissue disease
• Polyarteritis nodosum
• Primary CNS vasculitis
• Sarcoidosis
• Behçet’s syndrome
• Wegener’s granulomatosis
METABOLIC DISEASE ASSOCIATED WITH STROKE
• Homocystinuria
• Pseudoxanthoma elasticum
• Fabry’s disease
• Sulfite oxidase deficiency
• Mitochondrial disorders: mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke (MELAS); Leigh syndrome
• Ornithine transcarbamylase deficiency
INTRACEREBRAL VASCULAR PROCESSES
• Ruptured aneurysm
• Arteriovenous malformation
• Fibromuscular dysplasia
• Moyamoya disease
• Migraine headache
• Post subarachnoid hemorrhage vasospasm
• Hereditary hemorrhagic telangiectasia
• Sturge-Weber syndrome
• Carotid artery dissection
• Post varicella
TRAUMA AND OTHER EXTERNAL CAUSES
• Child abuse
• Head trauma/neck trauma
• Oral trauma
• Placental embolism
• Extracorporeal membrane oxygenation (ECMO) therapy