Ischemic stroke in infancy, childhood, and adolescence

Wanifuchi, Hiroshi; Kagawa, Mizuo; Takeshita, Mikihiko; Izawa, Masahiro; Kitamura, K

doi:10.1007/bf00270611

Cited by 18 publications

(6 citation statements)

References 21 publications

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“…The data presented here would suggest that global outcome is also related to the age of lesion acquisition and that children who experience an insult at a young age are especially vulnerable. However, although it has been suggested that other factors, such as the presence of an underlying risk factor for stroke (Dusser et al 1986, Wanifuchi et al 1988, Mancini et al 1997 or lesion location, particularly involvement of cortical tissue (Dusser et al 1986, Abram et al 1996 also have an influence on outcome, this was not evident in our group of patients. Possible reasons for this difference include improved management of associated conditions, such as cardiac disease, and that our measure of outcome was related to functional impairments.…”

Section: Discussioncontrasting

confidence: 68%

Outcome after ischaemic stroke in childhood

Ganesan

Hogan

Shack

et al. 2000

Develop Med Child Neuro

104

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A parental questionnaire was used to investigate the outcome for children who had had ischaemic stroke, who were seen at Great Ormond Street Hospital, London between 1990 and 1996. The results of functional assessments carried out by a physiotherapist and an occupational therapist, and of quantitative evaluations carried out by a neuropsychologist were used for validation where possible. The relationship between clinical and radiological factors and outcome were examined. The children were aged between 3 months and 15 years at the time of stroke (median age 5 years) and the period of follow‐up ranged from 3 months to 13 years (median duration 3 years). Of the 90 children for whom data were obtained, 13 (14%) had no residual impairments. Outcome was good in 37 children (40%) and poor in 53 (60%) (defined according to whether impairments interfered with daily life). Agreement, as measured by Cohen's kappa, was good or very good between the parents’responses and the qualitative measures provided by the medical professionals and the therapists, but only fair to moderate for the quantitative measures provided by the neuropsychologists. This may reflect different parental perceptions of the physical and cognitive aspects of outcome. Younger age at time of the stroke was the only significant predictor of adverse outcome.

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Section: Discussioncontrasting

confidence: 68%

Outcome after ischaemic stroke in childhood

Ganesan

Hogan

Shack

et al. 2000

Develop Med Child Neuro

104

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“…Eleven patients (29.7%) in these series recovered completely within a mean follow-up period of 4.2 years. Thirteen (35%) patients had post-infarction seizures, which could be controlled easily using antiepileptic medications, as reported by others (13,16,18). Twenty-three patients were left with a motor handicap and 13 experienced cognitive impairment which improved gradually.…”

Section: Discussionmentioning

confidence: 69%

“…Previous studies that have reported on the clinical presentation and outcome of pediatric stroke have classified the etiology and pathology using diagnostic measures, such as pneumoencephalogram, cerebral angiography, and post-mortem autopsies (1, 3-10). More recent studies (11)(12)(13)(14)(15)(16)(17)(18)(19), which included routine CT and lately MRI of the brain, improved substantially stroke subtype recognition into either ischemic or hemorrhagic.…”

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confidence: 99%

Predictors of outcome of stroke in infants and children based on clinical data and radiologic correlates

et al. 1994

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Outcome predictors were analyzed in 45 infants and children with cerebrovascular disorders (CVD), based on clinical features and radiological correlates. The clinical features at presentation could be categorized into three major groups: (1) generalized: alteration of consciousness with or without seizures--24 patients (54%); (2) focal: acute hemiplegia or monoplegia with or without focal seizures--18 patients (40%); (3) cerebellar disturbances--3 patients (6%). The underlying etiology was detected in 80% of children. Thirty-seven patients (82%) survived the initial debilitating event, of whom 11 (29.7%) recovered completely and the rest had either motor or cognitive handicaps during an average follow-up period of 4.2 years (range 1.5-11 years). A head CT performed in all children revealed ischemic infarction in 29 patients (64.4%), while the others had hemorrhagic infarction. Of those with an initial generalized neurological presentation, as many as 50% had multi-focal lesions on CT. All children with focal neurological findings had a solitary localized lesion on CT, mainly in the distribution of the middle cerebral artery. Statistical analysis for outcome prediction showed that the following variables were associated with increased risk of immediate death: (1) hemorrhagic infarction demonstrated by brain CT (p = 0.031); (2) patients who presented with a generalized neurological disorder, namely alteration of consciousness, with or without seizures (p = 0.036). No other clinical or laboratory variables were predictive of imminent death, motor or cognitive handicaps. These may therefore serve as outcome predictors of stroke in the pediatric age group.

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“…8,11,12,18) Occlusion of the intracranial vessels is less commonly caused by hematologic disorders or coagulopathies, and collagen vascular diseases (such as fibromuscular dysplasia, neurofibromatosis, etc.). 7,9,14,16) Arteriosclerosis is an uncommon etiology of cerebral ischemia in children, although a major cause of cerebrovascular disease in adults.…”

Section: Introductionmentioning

confidence: 99%

Internal Carotid Artery Occlusion Following Correction of Atypical Aortic Coarctation-Case Report-

Isobe

Oki

Sumida

et al. 2005

Neurol. Med. Chir.(Tokyo)

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An 11-year-old boy developed occlusion of the left internal carotid artery (ICA) following surgical correction of atypical coarctation of the aorta. The patient was admitted to our hospital after presenting with severe hypertension secondary to abdominal aortic hypoplasia and renal artery stenosis. Reconstruction of the abdominal aorta with bypass grafting was performed without complication. However, in the postoperative period, the patient experienced recurrent transient ischemic attacks manifesting as paresthesia of the right upper limbs, dysarthria, and right-sided weakness. Cerebral angiography revealed occlusion of the C 2 portion of the left ICA and decreased resting cerebral blood flow in the left hemisphere. Extracranial-intracranial arterial bypass was performed, and the patient suffered no further adverse neurological events. Coarctation of the aorta is an uncommon congenital condition that may result in cerebral ischemic disease. The cerebrovascular circulation should be evaluated, even in patients without a pre-existing history of cerebral ischemic symptoms.

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Ischemic stroke in infancy, childhood, and adolescence

Cited by 18 publications

References 21 publications

Outcome after ischaemic stroke in childhood

Outcome after ischaemic stroke in childhood

Predictors of outcome of stroke in infants and children based on clinical data and radiologic correlates

Internal Carotid Artery Occlusion Following Correction of Atypical Aortic Coarctation-Case Report-

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