Patterns of cerebral arterial injury in children with neurological disabilities

We reviewed the data from 215 consecutively imaged children who were referred because of neurologic disease. We specifically looked for evidence of cerebral arterial infarction in the form of focal brain damage in an arterial vascular distribution. Twenty-eight showed an arterial infarction pattern. All the major cerebral arteries were involved: middle cerebral artery, 17/28; posterior cerebral artery, 7/28; anterior cerebral artery, 2/28; carotid, 2/28; and vertebro-basilar, 1/28. Six of the 28 subjects had disorders reported to be associated with cerebrovascular damage. Another 13 subjects had other associated disorders, including perinatal distress and presumed anoxia, closed head trauma, hydrocephalus, and dehydration with electrolyte imbalance. Despite a careful search of medical records, we were unable to find any evidence of an adverse event or associated illness for more than one third of the children. These data suggest that cerebral arterial infarction is a more common lesion in the static neurologic disabilities of childhood than previously thought.