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Acute ischemic stroke in adolescents.

Thomas Rambaud1, Nicolas Legris1, Yannick Bejot1

  • 1From the Stroke Units and Department of Neurology (T.R., N.L., C.D.), Hôpital Bicêtre, Le Kremlin Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University; Department of Neurology (Y.B.), University Région Bourgogne, Hôpital de Dijon; Pediatric Neurology Unit (C.B.), Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre; Stroke Units and Department of Neurology (B.L.), Hôpital Foch, Suresnes; Department of Neurology (E.J.), Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris; Department of Neurology (F.P.), Hôpital Andre Mignot, Versailles; Department of Neurology (D.S.), Hôpital Sud Francilien, Evry; Department of Neurology (M.Z.), Hôpital Saint Joseph, Paris; Department of Neurology (S.C.), Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris; Department of Neurology (C.L.), Hôpital Sainte Anne, Paris; Interventional Neuroradiology (L.S.), NEURI Centre, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre; French National Health Insurance (P.T.); and Pediatric Neurology Unit (M.K.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, France.

Neurology
|December 14, 2019
PubMed
Summary
This summary is machine-generated.

Ischemic strokes in adolescents present unique challenges, often misdiagnosed initially. However, recanalization treatments are safe and effective, leading to favorable outcomes in most cases.

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Area of Science:

  • Neurology
  • Pediatrics
  • Vascular Medicine

Background:

  • Adolescent ischemic stroke is understudied, bridging pediatric and adult neurology.
  • Limited data exists on clinical features, causes, and outcomes in this age group.

Purpose of the Study:

  • To characterize clinical and neuroradiologic features of ischemic stroke in adolescents.
  • To identify etiologies, management strategies, and outcomes in adolescent stroke patients.

Main Methods:

  • Retrospective cohort study of 60 adolescent patients (10-18 years) with first-ever ischemic stroke.
  • Data collected from 10 French academic centers (2007-2017), validated with national database.

Main Results:

  • 36% of adolescent strokes were initially misdiagnosed, particularly posterior circulation strokes.
  • Recanalization therapy (IV thrombolysis, endovascular) was used in 32% with good safety.
  • Cardioembolism, vasculitis, and arterial dissection were common causes; 50% remained cryptogenic.
  • Recurrence occurred in 12% of patients; 80% had favorable functional outcomes at 90 days.

Conclusions:

  • Adolescent ischemic stroke requires a multidisciplinary approach, integrating pediatric and adult care.
  • Recanalization therapies are feasible and safe in this population.
  • Further research into cryptogenic strokes and specific etiologies is warranted.