Comparison of Risk Factors and Outcomes in Pediatric Posterior and Anterior Circulation Arterial Ischemic Stroke: A Cross-Sectional Analysis

Amirreza Jahanshahi ¹, Mahsa Niknam ¹, Sina Raeisi ²

⁰Department of Radiology, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Iranian Journal of Child Neurology +

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November 10, 2025

View abstract on PubMed

Summary

Pediatric arterial ischemic stroke (AIS) subtypes, anterior (ACAIS) and posterior (PCAIS), showed no significant differences in demographics, lipids, or prothrombotic factors. Further research is needed for better pediatric stroke management.

Area Of Science

Neurology
Pediatrics
Vascular Medicine

Background

Pediatric arterial ischemic stroke (AIS) is a critical condition with lasting neurological deficits.
AIS is categorized into anterior circulation AIS (ACAIS) and posterior circulation AIS (PCAIS), requiring distinct diagnostic and management approaches.
Understanding subtype-specific characteristics is crucial for improving outcomes in pediatric stroke.

Purpose Of The Study

To compare the demographic, clinical, and laboratory features of pediatric ACAIS and PCAIS.
To investigate differences in lipid profiles, prothrombotic factors, and SARS-CoV-2 prevalence between ACAIS and PCAIS.
To inform early diagnosis and effective management strategies for pediatric stroke subtypes.

Main Methods

A descriptive-analytical cross-sectional study included 34 pediatric AIS patients.
Patients were classified into ACAIS, PCAIS, or mixed groups based on neuroimaging.
Data analyzed included demographics, medical history, coagulation factors, lipid profiles, and SARS-CoV-2 antibodies.

Main Results

ACAIS was diagnosed in 73.5% of patients, PCAIS in 20.6%, and mixed in 5.9%.
PCAIS patients were older (median 8.0 years) than ACAIS patients (median 2.0 years).
No significant differences were found in lipid profiles, coagulation factors, or SARS-CoV-2 prevalence between ACAIS and PCAIS groups.

Conclusions

Pediatric ACAIS and PCAIS share similar demographic, lipid, and prothrombotic profiles.
These findings suggest potential differences in pediatric stroke mechanisms compared to adults.
Larger studies are necessary to confirm these results and enhance pediatric stroke care.

Keywords:

Anterior cerebral artery Blood coagulation factors Infarction Ischemic stroke Pediatrics Posterior cerebral artery