Association Between Prolonged Seizures and Malignant Middle Cerebral Artery Infarction in Children With Acute Ischemic Stroke

Andrade, Andrea; Bigi, Sandra; Laughlin, Suzanne; Parthasarathy, Sujatha; Sinclair, Adriane; Dirks, Peter B.; Pontigon, Ann Marie; Moharir, Mahendranath; Askalan, Rand; MacGregor, Daune; deVeber, Gabrielle

doi:10.1016/j.pediatrneurol.2016.08.015

Cited by 16 publications

(21 citation statements)

References 30 publications

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“…In our cohort, development of MMCAI occurred in 17 patients (ie, 17% of all MCA strokes) and was more frequent in patients receiving recanalization treatment than in the SC group. The frequency of MMCAI ranges between 1.3% and 18% in pediatric AIS patients and is associated with higher baseline pedNIHSS as shown in our cohort . Therefore, the higher frequency of MMCAI in the recanalization group is likely to be an epiphenomenon of more severe infarcts, rather than a complication attributable to the treatment modality itself.…”

Section: Discussionsupporting

confidence: 52%

“…The frequency of MMCAI ranges between 1.3% and 18% in pediatric AIS patients and is associated with higher baseline pedNIHSS as shown in our cohort. [27][28][29] Therefore, the higher frequency of MMCAI in the recanalization group is likely to be an epiphenomenon of more severe infarcts, rather than a complication attributable to the treatment modality itself.…”

Section: Severity Of Aismentioning

confidence: 99%

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Feasibility, safety, and outcome of recanalization treatment in childhood stroke

Bigi

Dulcey

Gralla

et al. 2018

Annals of Neurology

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Section: Discussionsupporting

confidence: 52%

Section: Severity Of Aismentioning

confidence: 99%

Feasibility, safety, and outcome of recanalization treatment in childhood stroke

Bigi

Dulcey

Gralla

et al. 2018

Annals of Neurology

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“…86,98 In children, initial stroke severity measured by the Pediatric NIH Stroke Scale directly predicts outcome. 99,100 Hence, the risks of thrombectomy may outweigh the benefits in children with low initial stroke severity scores.…”

Section: Recanalization Therapy: Thrombolytics and Endovascular Thrommentioning

confidence: 99%

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Ferriero¹,

Fullerton²,

Bernard³

et al. 2019

Stroke

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494

515

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Purpose-Much has transpired since the last scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee and were chosen to reflect the expertise of the subject matter. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. This scientific statement is based on expert consensus considerations for clinical practice. Results-Annualized pediatric stroke incidence rates, including both neonatal and later childhood stroke and both ischemic and hemorrhagic stroke, range from 3 to 25 per 100 000 children in developed countries. Newborns have the highest risk ratio: 1 in 4000 live births. Stroke is a clinical syndrome. Delays in diagnosis are common in both perinatal and childhood stroke but for different reasons. To develop new strategies for prevention and treatment, disease processes and risk factors that lead to pediatric stroke are discussed here to aid the clinician in rapid diagnosis and treatment. The many important differences that affect the pathophysiology and treatment of childhood stroke are discussed in each section. Conclusions-Here we provide updates on perinatal and childhood stroke with a focus on the subtypes, including arterial ischemic, venous thrombotic, and hemorrhagic stroke, and updates in regard to areas of childhood stroke that have not received close attention such as sickle cell disease. Each section is highlighted with considerations for clinical practice, attendant controversies, and knowledge gaps. This statement provides the practicing provider with much-needed updated information in this field. (Stroke. 2019;50:e00-e00.

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“…It is critical for pediatric intensivists and other medical personnel to recognize malignant middle cerebral artery syndrome and herniation syndromes because these fatal conditions can be treated with lifesaving and functionsparing hemicraniectomy when recognized quickly. 22,26 The fact that the strokes or their direct sequelae are responsible for more than half of pediatric stroke deaths indicates that improved stroke recognition, earlier supportive care, more rapid intervention, and neuroprotective treatments are critical for decreasing mortality after stroke in the pediatric population.…”

Section: Figurementioning

confidence: 99%

Mortality After Pediatric Arterial Ischemic Stroke

et al. 2018

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In-hospital mortality occurred in 2.6% of pediatric AIS cases. Most deaths were attributable to stroke. Risk factors for in-hospital mortality included congenital heart disease and posterior plus anterior circulation stroke. Presentation without seizures and Hispanic ethnicity were also associated with mortality for neonates and children, respectively. Awareness and study of risk factors for mortality represent opportunities to increase survival.

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Association Between Prolonged Seizures and Malignant Middle Cerebral Artery Infarction in Children With Acute Ischemic Stroke

Cited by 16 publications

References 30 publications

Feasibility, safety, and outcome of recanalization treatment in childhood stroke

Feasibility, safety, and outcome of recanalization treatment in childhood stroke

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Mortality After Pediatric Arterial Ischemic Stroke

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