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Published on: April 23, 2021
[Cerebrovascular risk factors seen in a university hospital]
M Hernández Chávez1, C Samsó Zepeda1, M López Espejo1
1Sección Neurología Pediátrica, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Pediatric ischemic stroke risk factors vary by age and stroke type. Identifying these factors aids in early diagnosis, treatment, and prevention strategies for children.
Area of Science:
- Neurology
- Pediatrics
- Vascular Medicine
Context:
- Pediatric ischemic stroke presents unique risk factors compared to adults.
- These factors include a broad spectrum of conditions like heart disease, infections, leukemias, and metabolic disorders.
Purpose:
- To characterize risk factors for ischemic stroke in children and adolescents.
- To investigate associations between risk factors, patient age, sex, and stroke classification (arterial vs. venous).
Summary:
- A study of 114 pediatric ischemic stroke cases revealed multiple risk factors in most patients.
- Common factors included acute systemic diseases (56.1%), heart disease (35.1%), and chronic systemic diseases (29.8%).
- Specific associations were found between acute systemic disease and younger children (<5 years), chronic systemic disease and older children (≥5 years), heart disease and arterial infarction, and head/neck disease and venous infarction.
Impact:
- Findings highlight the multifactorial nature of pediatric ischemic stroke.
- Understanding age- and type-specific risk factors can guide targeted primary prevention, early diagnosis, and effective management strategies to prevent recurrence.
Introduction:
Risk factors (RF) in pediatric stroke differ from those of adults, and they include a wide range of diseases such as heart disease, infections, leukemias, and inborn errors of metabolism.
Objectives:
To describe RF for ischemic stroke in a pediatric population, and to examine the relationship of RF with age, sex and type of stroke.
Patients And Methods:
An analysis was made of database of 114 children and adolescents with ischemic stroke from January 2003 to July 2012. Risk factors were stratified into 6 categories and ischemic strokes were classified as arterial and venous. We compared the RF with age, sex, and type of stroke (chi2 and OR).
Results:
The median age was 2.5 years, with 74 (62.2%) males. No RF was identified in 7.9% of patients, and 67% had more than one RF. The most common RF were acute systemic diseases (56.1%), heart disease (35.1%), and chronic systemic diseases (29.8%). There was a statistically significant association between acute systemic disease and age less than 5 years (P<.001), and between chronic systemic disease and age 5 years or more (P<.02). The RF of heart disease was associated with arterial infarction (P<.05), and the acute head and neck disease RF was associated with venous infarction (P<.05).
Conclusions:
The RF for ischemic stroke are multiple in the pediatric population, and some of them are associated with a specific age and type of stroke. The detection of these factors may help in the primary prevention of people at risk, an early diagnosis, and treatment and prevention of recurrences.
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