Optical Measurement of Cerebral Hemodynamics in Children With Acute Arterial Ischemic Stroke



Status:Recruiting
Conditions:Peripheral Vascular Disease, Neurology
Therapuetic Areas:Cardiology / Vascular Diseases, Neurology
Healthy:No
Age Range:2 - 18
Updated:12/19/2018
Start Date:February 2012
End Date:February 2020
Contact:Daniel L Licht, MD
Email:licht@email.chop.edu
Phone:267-426-0122

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Optical Measurement of Cerebral Hemodynamics in Children With Acute Arterial Ischemic Stroke: A Pilot Study

Acute ischemic stroke affects roughly 1 in 50,000 children every year and is one of the top
ten causes of death in children. Currently, caregivers lay the affected child flat in hopes
of increasing blood flow to the brain and reducing the volume of the brain which is damaged.
However, there are currently no techniques to measure brain blood flow at the child's bedside
and indicate if this treatment is effective. We will probe brain blood volume, oxygen
saturation, and flow with red light to determine the efficacy of this intervention.

Arterial ischemic stroke (AIS) affects about 2 children per 100,000 per year and is one of
the top 10 causes of mortality in children. After stroke, there is a disturbance in cerebral
blood flow (CBF) autoregulation, and changes in head position may change CBF. Currently,
practice at the Children's Hospital of Philadelphia (CHOP) is to keep the head of bed (HOB)
of a child with AIS flat for 24 hours; however, there is no evidence that this practice is
efficacious in children. Furthermore, maintaining a child supine for 24 hours is
uncomfortable for the child and is often unenforceable in younger children. This study will
use a noninvasive optical technique to measure CBF as HOB position is changed to assess the
effectiveness of head of bed position in increasing CBF in children with acute arterial
ischemic stroke.

The primary objectives are to determine the difference in CBF at HOB flat (0 degrees) and HOB
at +30 degrees in healthy children and in children with AIS. The secondary objectives are to
examine CBF in healthy children and in children with AIS at other HOB angles (0, +15, and +30
degrees) compared to the CBF at HOB 0 degrees and to determine if the position that maximizes
CBF varies over time from stroke onset.

Inclusion Criteria Healthy Control Subjects

1. Subjects age 2-18 years inclusive

2. No history of congenital or acquired brain injury

3. No history of developmental delay, mental retardation, genetic or metabolic syndrome
affecting the brain

Inclusion Criteria AIS Subjects

1. Subjects age 2-18 years inclusive

2. 72 hours or less from stroke onset

3. MRI or CT confirmation of AIS

Exclusion Criteria for All Subjects

1. Skull defect preventing application of probes

2. Moyamoya disease

3. Sickle cell anemia
We found this trial at
1
site
South 34th Street
Philadelphia, Pennsylvania 19104
 215-590-1000
Phone: 267-426-0122
Children's Hospital of Philadelphia Since its start in 1855 as the nation's first hospital devoted...
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