Related Experiment Video
Updated: Jul 17, 2026
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Arterial Ischemic Stroke in Pediatric Patients: A Tertiary Hospital Experience
Margarida Camacho-Sampaio1, Mariana Costa1, Cláudia Lima1,2
1Pediatric Neurology, Hospital Pediátrico, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Insights
Childhood arterial ischemic stroke is rare but causes significant morbidity. Prompt diagnosis and treatment are crucial, as conservative measures are common, but invasive treatments show promise.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Vascular Neurology
Background:
- Childhood arterial ischemic stroke (CAIS) is an underdiagnosed condition with significant mortality and morbidity.
- Outcomes for CAIS are generally favorable but require prompt identification and management.
Purpose of the Study:
- To characterize patients with childhood arterial ischemic stroke.
- To analyze risk factors, etiology, treatment, and outcomes in pediatric stroke patients.
Main Methods:
- Retrospective observational study of patients aged 28 days to 18 years.
- Data collected from a tertiary hospital in Coimbra, Portugal (2015-2022).
- Analysis of demographic and clinical data.
Main Results:
- 19 pediatric patients with CAIS included; median age 12.13 years.
- Most common etiologies were cardioembolic and unilateral focal cerebral arteriopathy (37% each).
- Conservative treatment was primary (90%), with successful mechanical thrombectomy in 2 patients; 21% experienced moderate to severe disability.
Conclusions:
- CAIS presents with focal deficits and non-localizing symptoms.
- Conservative treatment is prevalent, yet invasive methods yield good results.
- High clinical suspicion is vital for early diagnosis and treatment of CAIS to mitigate morbidity.
Introduction:
Childhood arterial ischemic stroke is a rare condition. Its true incidence is unknown as it is likely underdiagnosed. Outcomes are generally favorable but it is still a significant cause of mortality and morbidity in children. We aimed to characterize patients with childhood arterial ischemic stroke regarding risk factors, etiology, treatment, and outcome.
Methods:
This was a retrospective observational study that analyzed demographic and clinical data of patients aged 28 days to 18 years of age diagnosed with arterial ischemic stroke and admitted to the neuropediatric department at a tertiary hospital in Coimbra, Portugal, between 2015 and 2022.
Results:
A total of 19 patients were included, with a median age of 12.13 years; 10 (53%) were male children and 13 (63%) had a pre-existing medical condition. Eleven patients (58%) presented with sudden focal deficit and eight (42%) with only unspecific/non-localizing symptoms (headache, altered mental status, and seizure). The middle cerebral artery was the most affected (n=13, 68%) and regarding etiology, seven (37%) were cardioembolic and another seven (37%) were unilateral focal cerebral arteriopathy. Conservative measures were used for the treatment of 11 (90%) patients and two underwent mechanical thrombectomy successfully. Regarding sequelae, four patients (21%) had moderate to severe disability. The main sequelae was chronic motor deficit (n=8, 42%), followed by cortical deficit (n=4, 21%). Two patients developed vascular epilepsy.
Conclusions:
While most patients presented with a sudden focal deficit, the occurrence of non-localizing symptoms was high. Conservative treatment was the most used, but there were good results in patients submitted to invasive treatment. Our results corroborate the high morbidity associated with childhood arterial ischemic stroke and the need for a high clinical suspicion to identify these cases and treat them promptly.
Related Concept Videos
01:29Stroke: Introduction and Types
01:15Ischemic Stroke l: Introduction
01:15Ischemic Stroke ll: Pathophysiology
01:17Hemorrhagic Stroke l: Introduction
01:29Hemorrhagic Stroke ll: Pathophysiology