Surgery

The need for surgical treatment for pediatric stroke will depend on a number of factors, including the type of stroke, extent of damage from stroke, the child's age, and potential benefits and risks. Sometimes urgent surgery is necessary soon after the child is admitted to the emergency room to remove a blood clot and restore oxygen flow to the brain tissue.

Treatment options for hemorrhagic stroke may include surgery, sterotactic radiotherapy, or interventional neuroradiology to treat the underlying aneurysm or arteriovenous malformation.

There are several surgical procedures to repair an aneurysm that may have caused a hemorrhagic stroke. A clip may be placed across the neck of the aneurysm (like a clip at the end of a balloon) to stop the bleeding. A newer approach is to thread a long, thin tube through the artery that leads to the aneurysm. Then a tiny coil is fed through the tube into the aneurysm "balloon" to fill the space and seal off the bleeding.

An interventional procedure called carotid angioplasty may be performed to treat a blockage or blockages in the carotid arteries. During the procedure, a tiny balloon at the end of a long, thin tube (called a catheter) is pushed through the artery to the blockage. When the balloon is inflated, it opens the artery. In addition, a mesh tube (called a stent) may be placed inside the artery to help hold it open.

Carotid endarterectomy is a surgical procedure performed to remove a blockage from the carotid artery. During the operation, the surgeon scrapes away plaque from the wall of the artery so blood can flow freely through the artery to the brain.

Intracranial bypass surgery is a surgical procedure performed to restore blood flow around a blocked blood vessel in the brain. During the surgery, a healthy blood vessel, on the outside of the scalp, is re-routed to the part of the brain that is not getting enough blood flow. This new blood vessel bypasses the blocked vessel and provides an additional blood supply to areas of the brain that were deprived of blood. When blood flow is restored, the brain works normally, and the symptoms disappear. This procedure is not as common as the other surgical treatments listed above to treat pediatric stroke but it may be used to treat recurrent TIAs.