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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

A right-to-left shunt and prothrombotic disorders in pediatric patients presenting with transient ischemic attack

Mirjana Perkovič-Benedik1, Marjan Zaletel, Nuška Pečarič-Meglič

  • 1Department of Pediatrics, University Medical Center Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia.

European Journal of Pediatrics
|October 31, 2012
PubMed

Insights

Right-to-left shunt (RLS) and prothrombotic disorders are more common in pediatric patients with transient ischemic attack (TIA). These findings suggest paradoxical embolism plays a role in pediatric TIA.

Area of Science:

  • Neurology
  • Pediatrics
  • Cardiology

Background:

  • Arterial ischemic stroke is a significant cause of disability and death in children.
  • A right-to-left shunt (RLS) through a patent foramen ovale is a potential risk factor for pediatric stroke.
  • Limited data exists on RLS and prothrombotic disorders in pediatric patients experiencing transient ischemic attack (TIA).

Purpose of the Study:

  • To compare the prevalence and severity of RLS in pediatric TIA patients versus controls using contrast transcranial Doppler with Valsalva maneuver.
  • To identify prothrombotic disorders in pediatric TIA patients.

Main Methods:

  • Twenty-three pediatric patients with TIA were studied.
  • Contrast transcranial Doppler with Valsalva maneuver was used to assess RLS.
  • Logistic regression analysis was employed to determine associations.

Main Results:

  • RLS was significantly associated with TIA (OR 4.75, p=0.013).
  • The prevalence of RLS was higher in TIA patients compared to controls (p=0.019).
  • Microembolic signals (MES) were more frequent in TIA patients (p=0.003).
  • Prothrombotic disorders were found in 14 out of 23 patients.

Conclusions:

  • Pediatric patients with TIA exhibit a higher prevalence of RLS and MES compared to controls.
  • Prothrombotic disorders are prevalent in this patient group.
  • These findings indicate that paradoxical embolism may be a key factor in pediatric TIA.

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