Strokes in Children

Gumer, Lindsey; Vecchio, Michael Del; Aronoff, Stephen C.

doi:10.1097/pec.0000000000000218

Cited by 22 publications

(14 citation statements)

References 17 publications

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“…Moyamaya disease/syndrome accounts for 21.6% of children with AIS and approximately 12% of all types of stroke in our study. These findings are similar to previous systemic reviews that 11% of children with stroke were diagnosed with Moyamoya syndrome 19 …”

Section: Discussionsupporting

confidence: 92%

“…An AVM rupture was identified as the most common etiology in HS in our study. This finding is the same as other reports that hemorrhagic vascular malformation, specifically AVM, is the most common and accounted for 30% of children with HS 3,19,20 . Using logistic regression to identify risk factors of both AIS and HS, we could not find any significant risk factors in AIS.…”

Section: Discussionsupporting

confidence: 90%

“…The etiologies of AIS and HS are different. In AIS, steno-occlusive arteriopathy has been found as one of the leading causes followed by cardiac-related conditions 14,17,19,22 . Moyamaya disease/syndrome accounts for 21.6% of children with AIS and approximately 12% of all types of stroke in our study.…”

Section: Discussionmentioning

confidence: 54%

“…The overall median age of stroke onset of both AIS and HS was 6 years in our study. The age of onset is lower than the average age of onset from a systemic review, which was reported at 8.2 years 19 . This could be because of the differences in racial, type of stroke, population characteristics among studies.…”

Section: Discussionmentioning

confidence: 72%

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Comparison of Arterial Ischemic and Hemorrhagic Pediatric Stroke in Etiology, Risk Factors, Clinical Manifestations, and Prognosis

Pangprasertkul¹,

Borisoot²,

Buawangpong³

et al. 2022

Pediatr Emer Care

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BackgroundStroke is relatively rare in children but has a significant impact on long-term morbidity and mortality. There are limited data regarding the etiology, clinical manifestation, and prognosis of arterial ischemic stroke (AIS) and hemorrhagic stroke (HS) in children.ObjectiveThe aim of this study is to identify and compare etiology, risk factors, clinical manifestations, and prognostic outcomes between arterial ischemic and hemorrhagic pediatric stroke.MethodsWe retrospectively reviewed all hospital medical records and pediatric neurology database of 83 children who were first diagnosed with AIS and HS at the Pediatric Department, Chiang Mai University Hospital, Chiang Mai, Thailand between January 1, 2009, and December 31, 2018. All children were from 1 month to 18 years old.ResultsFifty-one AIS (56%) and 32 (35.2%) HS were identified. The median age of onset was 6.9 years for AIS and 5.3 years for HS. Moyamoya disease/syndrome was the most common cause in AIS (21.6%). Rupture of cerebral arteriovenous malformation was the most common cause in HS (21.9%). More than one-third (39%) of children had multiple risk factors associated with stroke. Iron deficiency anemia was commonly found in children with AIS (39.2%). The majority of clinical presentations were hemiparesis (80.4%) for AIS and alteration of consciousness (68.8%) for HS. The median time to diagnosis exceeded 6 hours in both AIS and HS. The overall mortality rate of acute stroke was 5.1 per 100 person-years (95% confidence interval [CI], 2.9–9). The mortality rate was higher in HS compared with that in AIS with statistical significance (16.6; 95% CI, 8.9–30.8 vs 1.1%; 95% CI, 0.3–4.6 per 100 person-years). Thirty children (36.1%) developed epilepsy during the follow-up (median duration, 26 months). Recurrent stroke occurred in 1 child with AIS and 1 child with HS.ConclusionsMoyamoya disease/syndrome and arteriovenous malformation rapture are the most common cause of AIS and HS, respectively. Iron deficiency anemia was commonly found in childhood AIS. The time to diagnosis in both AIS and HS was delayed. The mortality rate in HS was higher than in AIS. Neurological deficits are seen in 70% of childhood AIS during the follow-up. One-third of the children in our study developed epilepsy, which generally responds to a single antiseizure medication. The recurrence rate of childhood stroke was low compared with adult stroke.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 72%

See 2 more Smart Citations

Comparison of Arterial Ischemic and Hemorrhagic Pediatric Stroke in Etiology, Risk Factors, Clinical Manifestations, and Prognosis

Pangprasertkul¹,

Borisoot²,

Buawangpong³

et al. 2022

Pediatr Emer Care

View full text Add to dashboard Cite

show abstract

“…Pediatric stroke is an acute neurologic deficit persisting for at least 24 h in patients 28 d to 18 yr resulting from a disturbance in cerebral blood flow (Gumer et al 2014). Stroke is typically defined as either ischemic or hemorrhagic, with hemorrhagic stroke accounting for ∼39%–54% of pediatric strokes and intracerebral hemorrhage (ICH) accounting for ∼23% (Lo 2011).…”

Section: Variant Interpretationmentioning

confidence: 99%