Risk Factors of Pediatric Stroke

Sutherly, Loretta J; Malloy, Rachel

doi:10.1097/jnn.0000000000000489

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…The incidence of childhood stroke ranges from 1.3–13 per 100,000 children per year 1 , and boys are twice as likely to be affected as girls 2 . The etiology, presentation, and prognosis of stroke in children differ from those in adults 3 and, although specific risk factors have been identified, the etiology of pediatric stroke often remains unclear 4 . Survivors of childhood stroke suffer from motor 5 and cognitive restrictions 6 – 9 .…”

Section: Introductionmentioning

confidence: 99%

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Steiner

Federspiel

Jaros

et al. 2021

Sci Rep

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Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric AIS. This cross-sectional study investigated CBF and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed with neuropsychological tests, CBF was measured with arterial spin labeled imaging in the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls (p < 0.026) but mean performance was within the normal range in all cognitive domains. Arterial spin labeled imaging revealed significantly lower CBF in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after a pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and that interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.

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Section: Introductionmentioning

confidence: 99%

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Steiner

Federspiel

Jaros

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Strokes within the pediatric population are considered to be the 10th leading cause of death in the United States of America (USA), with over half of such events occurring in children younger than one year of life [1]. It is important to note that higher mortality rates (up to 25%) are for hemorrhagic stroke, while lower mortality rates (up to 10%) are associated with arterial ischemic stroke (AIS) [2].…”

Section: Introductionmentioning

confidence: 99%

The Genetic Basis of Strokes in Pediatric Populations and Insight into New Therapeutic Options

Janković

Petrović²,

Novaković

et al. 2022

IJMS

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Strokes within pediatric populations are considered to be the 10th leading cause of death in the United States of America, with over half of such events occurring in children younger than one year of life. The multifactorial etiopathology that has an influence on stroke development and occurrence signify the importance of the timely recognition of both modifiable and non-modifiable factors for adequate diagnostic and treatment approaches. The early recognition of a stroke and stroke risk in children has the potential to advance the application of neuroprotective, thrombolytic, and antithrombotic interventions and rehabilitation strategies to the earliest possible timepoints after the onset of a stroke, improving the outcomes and quality of life for affected children and their families. The recent development of molecular genetic methods has greatly facilitated the analysis and diagnosis of single-gene disorders. In this review, the most significant single gene disorders associated with pediatric stroke are presented, along with specific therapeutic options whenever they exist. Besides monogenic disorders that may present with stroke as a first symptom, genetic polymorphisms may contribute to the risk of pediatric and perinatal stroke. The most frequently studied genetic risk factors are several common polymorphisms in genes associated with thrombophilia; these genes code for proteins that are part of the coagulation cascade, fibrolysis, homocystein metabolism, lipid metabolism, or platelets. Single polymorphism frequencies may not be sufficient to completely explain the stroke causality and an analysis of several genotype combinations is a more promising approach. The recent steps forward in our understanding of the disorders underlying strokes has given us a next generation of therapeutics and therapeutic targets by which to improve stroke survival, protect or rebuild neuronal connections in the brain, and enhance neural function. Advances in DNA sequencing and the development of new tools to correct human gene mutations have brought genetic analysis and gene therapy into the focus of investigations for new therapeutic options for stroke patients.

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“…The incidence of childhood stroke ranges from 1.3-13 per 100,000 children per year [1], and boys are twice as likely to be affected as girls [2]. The etiology, presentation, and prognosis of stroke in children differ from those in adults [3] and, although specific risk factors have been identified, the etiology of pediatric stroke often remains unclear [4]. Survivors of childhood stroke suffer from motor [5] and cognitive restrictions [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Steiner

Federspiel

Jaros

et al. 2021

Preprint

View full text Add to dashboard Cite

Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric arterial ischemic stroke (AIS). This cross-sectional study investigated cerebral blood flow and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed using neuropsychological tests and cerebral blood flow was measured with arterial spin labeled imaging in the area of the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls. Arterial spin labeled imaging revealed significantly lower cerebral blood flow in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.

show abstract

Risk Factors of Pediatric Stroke

Cited by 3 publications

References 11 publications

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

The Genetic Basis of Strokes in Pediatric Populations and Insight into New Therapeutic Options

Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery

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