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Updated: Jun 18, 2026
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Acute arterial ischemic stroke in children: single-center experience
Muharrem Bostancı1, Arzu Ekici1, Cengiz Havalı1
1University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Pediatrics, Bursa, Turkey.
Insights
Childhood arterial ischemic stroke (AIS) requires prompt diagnosis and physical therapy. Early brain CT scans are crucial for identifying stroke, with MTHFR gene mutations and cardiac anomalies being common associated factors in pediatric AIS cases.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Genetics
Background:
- Childhood arterial ischemic stroke (AIS) is a significant cause of mortality and morbidity.
- Early diagnosis and treatment are critical for improving outcomes in pediatric AIS.
- Physical therapy should be initiated promptly.
Purpose of the Study:
- To highlight the importance of early diagnosis and treatment of AIS in children.
- To emphasize the need for early initiation of physical therapy in pediatric AIS cases.
- To review clinical findings, diagnostic methods, and associated conditions in childhood AIS.
Main Methods:
- Retrospective review of medical records of 23 pediatric patients (1 month to 18 years) diagnosed with AIS.
- Analysis of presenting neurological complaints, radiological findings (brain CT), genetic mutations (MTHFR), and concomitant conditions.
- Data collected between January 2016 and June 2020 at a tertiary healthcare facility.
Main Results:
- Neurological deficit was the most common presentation (52%), followed by seizures (21%) and facial paralysis (21%).
- Brain CT detected infarction in 8 out of 12 initial scans (66%), with cerebral involvement in 82% of cases.
- MTHFR gene mutations (A1298C and 677C>T) were frequently observed. Cardiac anomalies (30%) and ventriculoperitoneal shunts were also noted.
Conclusions:
- Pediatric AIS presents with diverse clinical signs, including unusual symptoms like hiccups and gaze paralysis.
- Cranial CT is vital for diagnosis in children, especially when MRI is not readily available.
- Conditions such as intracranial operations, shunts, and hypochondroplasia can increase stroke risk.
Abstract:
Arterial ischemic stroke (AIS) is an increasingly common disorder in childhood that causes severe mortality and morbidity.To emphasize the importance of early diagnosis and treatment of AIS cases, as well as the early initiation of physical therapy.We retrospectively reviewed the medical records of 23 patients aged 1 month to 18 years, who were admitted with acute neurological complaints and diagnosed radiologically with AIS at the Bursa Yüksek İhtisas Training and Research Hospital, a tertiary healthcare facility, between January 2016 and June 2020.Neurological deficit was the most common (12 patients; 52%) complaint, followed by seizure in 5 patients (21%), facial paralysis in 5 patients (21%), and visual impairment in 3 patients (13%). We performed brain computed tomography (CT) scans in 12 (52%) patients at the first application, and infarction was detected in 8 (66%). Infarction was in the cerebrum in 19 (82%) patients. Mutations of the methylenetetrahydrofolate reductase (MTHFR; A1298C and 677C > T) gene were found most frequently. Cardiac anomalies were detected in 7 (30%) patients, and 2 patients had ventriculoperitoneal shunts.Arterial ischemic stroke presents very different clinical findings, such as hiccups, anisocoria, and upward gaze paralysis. We wanted to emphasize the importance of cranial CT scanning because sometimes MRI is not always easily performed in children. Concomitant conditions, such as intracranial operation, ventriculoperitoneal shunt, and hypochondroplasia, may increase the risk of stroke.
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