[Clinical and neuroimaging signs of cardioembolic stroke in children]

Area of Science:

• Pediatric neurology
• Cardiology
• Neuroimaging

Background:

• Cardioembolic stroke (CES) is a significant cause of arterial ischemic stroke (AIS) in children.
• Accurate diagnosis of CES in pediatric patients is crucial for appropriate management and secondary prevention.
• Existing diagnostic criteria may require refinement for pediatric populations.

Purpose of the Study:

• To identify and characterize the clinical and neuroimaging signs specific to pediatric CES.
• To evaluate the utility of the CASSADE criteria in diagnosing CES in children.
• To establish additional clinical indicators for CES diagnosis, especially when neuroimaging is inconclusive.

Main Methods:

• A cohort of 100 pediatric patients (1 month to 15 years) with AIS was studied.
• Patients were divided into a CES group (10) and a non-CES AIS group (90).
• Diagnostic tools included CT, MRI, MR-angiography, ultrasound, and clinical assessments (PedNIHSS, PSOM).

Main Results:

• Specific clinical features associated with CES were identified, including early onset and rapid neurological deficit progression.
• High severity in the acute phase (PedNIHSS > 15) and significant residual symptoms (PSOM > 2) were noted.
• The study confirmed the relevance of CASSADE criteria and proposed additional clinical signs for CES diagnosis.

Conclusions:

• Clinical signs such as rapid neurological deficit development and early recovery can suggest CES in children.
• These clinical indicators, combined with CASSADE criteria, enhance CES diagnosis in pediatric AIS.
• Early recognition of CES is vital for timely intervention and improved outcomes in children.