Prothrombotic disorders and ischemic stroke in children

Area of Science:

• Pediatric Neurology
• Hematology
• Vascular Medicine

Background:

• Childhood stroke, encompassing arterial ischemic stroke (AIS) and sinovenous thrombosis (SVT), is uncommon but severe.
• Understanding the causes of pediatric stroke is vital for developing prevention strategies.
• Prothrombotic disorders are implicated in the etiology of childhood stroke.

Purpose of the Study:

• To review the role of prothrombotic disorders in childhood ischemic stroke.
• To highlight the incidence of these disorders in pediatric AIS and SVT.
• To recommend screening for prothrombotic disorders in children with stroke.

Main Methods:

• Literature review of studies on childhood stroke and prothrombotic disorders.
• Analysis of reported incidences of specific prothrombotic conditions.
• Synthesis of current understanding regarding the contribution of these disorders to stroke etiology.

Main Results:

• Prothrombotic disorders are found in 20-50% of childhood AIS and 33-99% of childhood SVT.
• Identified disorders include deficiencies in antithrombin, protein C, S, plasminogen, Factor V Leiden, Prothrombin gene mutations, dysfibrinogenemia, antiphospholipid antibodies, hyperhomocysteinemia, and elevated lipoprotein (a).
• Other contributing factors include hyperlipidemia, polycythemia, iron deficiency anemia, and platelet disorders.

Conclusions:

• Prothrombotic disorders are prevalent in children with stroke and likely play a causative role.
• Screening for these disorders in pediatric stroke patients is recommended.
• Further research is needed to define the exact contribution of specific disorders and optimize treatment.