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Investigation of risk factors in children with arterial ischemic stroke

Vijeya Ganesan1, Mara Prengler, Michael A McShane

  • 1Neurosciences Unit, University College London, United Kingdom. v.ganesan@ich.ucl.ac.uk

Annals of Neurology
|January 31, 2003
PubMed

Insights

Pediatric arterial ischemic stroke risk factors include anemia and MTHFR mutations. While cerebral artery imaging is often abnormal, cardiac and thrombophilia screenings are typically negative in children with stroke.

Area of Science:

  • Neurology
  • Pediatrics
  • Vascular Medicine

Background:

  • Childhood arterial ischemic stroke (AIS) is a rare but serious neurological event.
  • Identifying risk factors is crucial for prevention and management in pediatric populations.

Purpose of the Study:

  • To analyze the known risk factors in children experiencing their first arterial ischemic stroke.
  • To evaluate the utility of various diagnostic investigations in this cohort.

Main Methods:

  • Retrospective analysis of 212 children with first AIS over 22 years at a tertiary center.
  • Review of clinical history, physical examination, cerebral arterial imaging, echocardiography, and thrombophilia screening.
  • Statistical analysis to identify significant associations with stroke and arterial abnormalities.

Main Results:

  • Cerebral arterial imaging was abnormal in 79% of investigated patients.
  • Anemia (40%) and elevated homocysteine or MTHFR mutation (21%) were common.
  • Trauma and varicella zoster infection were more frequent in previously healthy children.
  • Elevated systolic blood pressure and recent varicella showed significant associations with arterial abnormalities.

Conclusions:

  • Clinical evaluation is key for identifying AIS triggers in children.
  • Cerebral arterial imaging frequently reveals abnormalities, whereas echocardiography and thrombophilia screening are often unrevealing.
  • Further research into specific risk factors like MTHFR mutations and infections is warranted.

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