Posterior Arterial Ischemic Stroke in Childhood.

Fink, Mirjam; Slavova, Nedelina; Grunt, Sebastian; Perret, Eveline; Regényi, Mária; Steinlin, Maja; Bigi, Sandra (2019). Posterior Arterial Ischemic Stroke in Childhood. Stroke, 50(9), pp. 2329-2335. American Heart Association 10.1161/STROKEAHA.119.025154

[img] Text
STROKEAHA.119.025154.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (437kB) | Request a copy

Background and Purpose- Literature on the clinical manifestation and neuroradiological findings in pediatric patients with posterior circulation arterial ischemic stroke is scarce. This study aims to describe epidemiological features, clinical characteristics, and neuroimaging data on pediatric posterior circulation arterial ischemic stroke in Switzerland using the population-based Swiss Neuropediatric Stroke Registry. Methods- Children aged from 1 month to 16 years presenting with an isolated posterior circulation arterial ischemic stroke between 2000 and 2016 were included. Epidemiology, clinical manifestation, stroke cause, and neuroradiological features were summarized using descriptive statistics. Stroke severity was assessed using the pediatric National Institutes of Health Stroke Scale. Correlation analysis was performed using the Spearman correlation coefficient. Results- Forty-three children with posterior circulation arterial ischemic stroke were included (27 boys [62.8%], median age 7.9 years, interquartile range, 5 to 11.7 years). The incidence of posterior circulation arterial ischemic stroke is Switzerland was 0.183/100 000 and represented 16% of all childhood arterial ischemic strokes. Most patients presented with nonspecific neurological complaints, such as headache (58.1%) and nausea/vomiting (46.5%). The most frequent clinical manifestations were ataxia (58.1%) and motor/sensory hemisyndrome (53.5%/51.2%). Unilateral focal cerebral arteriopathy was the most common cause (11 children, 25.6%). Most infarcts were located in the cerebellum (46.5%) and thalamus (39.5%). A shorter diagnostic delay correlated with more severe stroke symptoms at presentation (rho= -0.365, P=0.016). Conclusions- Pediatric posterior circulation arterial ischemic stroke was caused by focal cerebral arteriopathy in one quarter of the patients in our cohort. The frequently reported nonspecific clinical symptoms, especially when associated with mild neurological findings, risk delaying the diagnosis of stroke. A high index of suspicion and increased awareness are required for timely diagnosis and treatment initiation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neuropaediatrics
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Fink, Mirjam Sarah; Slavova, Nedelina Bozhidarova; Grunt, Sebastian; Perret, Eveline; Regényi, Mária; Steinlin, Maja and Bigi, Sandra

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1524-4628

Publisher:

American Heart Association

Language:

English

Submitter:

Karen Lidzba

Date Deposited:

21 Oct 2019 13:40

Last Modified:

22 May 2020 10:03

Publisher DOI:

10.1161/STROKEAHA.119.025154

PubMed ID:

31345132

Uncontrolled Keywords:

ataxia nausea neuroimaging pediatrics stroke

BORIS DOI:

10.7892/boris.134048

URI:

https://boris.unibe.ch/id/eprint/134048

Actions (login required)

Edit item Edit item
Provide Feedback