Neuroimaging in childhood arterial ischaemic stroke: evaluation of aetiologies and imaging modalities

Buerki, Sarah E.; Roellin, Katja; Remonda, Luca; Gubser-Mercati, Danielle; J, Py; Keller, E.; Lütschg, Jürg; Menache, Caroline C.; Gp, Ramelli; Schmitt‐Mechelke, Thomas; Weissert, M; Boltshauser, Eugen; Steinlin, Maja

doi:10.1055/s-2008-1079486

Cited by 5 publications

(6 citation statements)

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“…It occurs early (below 8 yr of age) in 41.66% of our patients. According to published reports, the mean age of childhood stroke varies from 4 yr and 7 mo to 13 yr [5,[7][8][9]10]. A male predominance was noted in our cohort, as reported by other authors [8,10,11], although a female predominance has also been reported [7].…”

Section: Discussionsupporting

confidence: 83%

“…In our study, ischemic stroke occurred most frequently in the middle cerebral artery territory and acute hemiplegia was the main clinical manifestation with seizures and expressive aphasia as seen in similar published reports [10,11,20]. Anterior cerebral artery's lesions are rare in the literature [8]. Seizures frequently occurred in the acute stage and were rarely isolated [13].…”

Section: Discussionsupporting

confidence: 81%

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Ischemic stroke in childhood: A Senegalese cohort

et al. 2015

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Ischemic stroke is infrequent in childhood. Etiological factors depend on epidemiological context. The purpose of this study is to determine risk factors, clinical and radiological features and outcome of arterial ischemic stroke in a cohort of Senegalese infants. We carried out a retrospective study of medical data of children hospitalized with arterial ischemic stroke in the neurological department of Fann teaching hospital and at Children's Hospital Albert Royer, from July 2003 to July 2011. Forty-eight cases were included in this study with ages ranging from 2 months to 18 yr, with a female/male ratio of 0.71. Mean age at the time of occurrence stroke was 89.37 mo. The most common symptoms were hemiparesis (93.75%), motor partial seizures (24.44%), and Broca's aphasia (33.3%). The middle cerebral artery was mostly affected (87.5%). Risk factors were predominantly sickle cell disease, anemia, embolic heart disease, meningoencephalitis and head trauma. 8.33% of patients died. After discharge, 16.66% of patients were lost follow-up and 62.5% of the total cohort had neurological impairments. Treatment was essentially symptomatic and secondary prevention was provided by treatment with anticoagulants or anti-platelets agents depending on the etiology of ischemic stroke.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

Ischemic stroke in childhood: A Senegalese cohort

et al. 2015

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“…The multifarious symptoms and the difficulties in diagnosis point to the importance of neuroimaging in a child with suspicion of childhood stroke, not only for diagnostic purposes, but also for evaluation of etiology and outcome. 32,33 Computed tomography has the advantage of being readily available in emergency, but the disadvantage of missing out on early, small, or infratentorial ischemia. The golden standard is certainly magnetic resonance imaging with diffusion weighted images, revealing the ischemia within minutes and giving early on an accurate measure of the extension of ischemic area (►Fig.…”

Section: Neuroimagingmentioning

confidence: 99%

A Clinical Approach to Arterial Ischemic Childhood Stroke: Increasing Knowledge over the Last Decade

Steinlin

2012

Neuropediatrics

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Childhood stroke is increasingly being recognized as an important burden not only for affected children and families, but also for socioeconomic reasons. A primary problem is delayed diagnosis, due to the many mimics of childhood stroke, and the variety of manifesting symptoms. The most important is hemiparesis (with/without dysphasia or facial palsy), but ataxia, seizures, and many more are also possible. Suspicion of stroke has to be ascertained by neuroimaging, gold standard being (diffusion weighted) magnetic resonance. Risk factors are multiple, but their presence might help to increase the suspicion of stroke. The most important factors are infectious/parainfectious etiologies, frequently possibly manifesting by transient focal cerebral arteriopathy (FCA). Cardiological underlying problems are the second most important. Arteriopathies can be detected in about half of the children, besides FCA and dissection and MoyaMoya disease are the most important. Hereditary coagulopathies increase the risk of stroke. There is still a controversy on best treatment in children: platelet antiaggregation and heparinization are used about equally. Thrombolysis is being discussed increasingly. Severity of symptoms at manifestation and on follow-up are not less significant in children than in young adults. About two-third of the children have significant residual neurological problems and a majority cognitive and behavior problems.

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“…74,75 Neuroimaging might play a major role for prognosis, but knowledge is still limited. 32,33,76 The burden of possible recurrence of stroke should not be neglected. Risk of recurrence is between 10 and 20%.…”

Section: Outcome and Prognosismentioning

confidence: 99%

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2012

Neuropediatrics

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Stroke is a rare, but terrifying and devastating disease in childhood. Over the last two decades, childhood stroke is increasingly being recognized as an important cause of childhood morbidity and ranges among the top 10 causes of death in children. 1-3 Thus childhood stroke is an important burden, not only for affected children and their families, but also for health insurances and socioeconomic reasons. The costs for pediatric stroke are substantial: In an North American study, the average cost of a childhood stroke admission was $81,869, the average adjusted 5 years costs are $135,161. 4 International data suggest an incidence of childhood stroke of 2 to 5/100,000 children per year. 1 Data from the Swiss Neuropediatric Stroke Registry suggest an incidence for arterial ischemic stroke (AIS) in childhood of 2.1/ 100,000 children per year. 5 There is a suggestion of a higher incidence, due to clinically unrecognized events. 6 For yet unknown reasons there is a worldwide male predominance in childhood stroke. 7,8 Many excellent reviews have been published recently. 1,9-12 There are three guidelines for treatment published. 13-15 This article will not attempt to give a review of the subject, but will try to guide a physician through many aspects one has to consider, dealing with a child with acute arterial ischemic stroke, from emergency to the long-term follow-up and giving some inputs on differential diagnosis, work-up, and treatment as linked to the symptoms and Keywords ► childhood stroke ► risk factors ► etiology ► treatment ► manifestation ► outcome

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Neuroimaging in childhood arterial ischaemic stroke: evaluation of aetiologies and imaging modalities

Cited by 5 publications

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Ischemic stroke in childhood: A Senegalese cohort

Ischemic stroke in childhood: A Senegalese cohort

A Clinical Approach to Arterial Ischemic Childhood Stroke: Increasing Knowledge over the Last Decade

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