Neurological Outcome and Risk of Recurrence Depending on the Anterior vs. Posterior Arterial Distribution in Children with Stroke

Abstract

We report the outcome of 46 previously healthy children with arterial ischemic stroke. After a mean follow-up of 26 months, five (11%) children suffered a recurrence and 28 (61%) were left with sequelae. The prevalence and the severity of the sequelae were similar irrespective of whether the localization of the accident was anterior or posterior. However, a recurrence was significantly more frequent in the posterior than in the anterior group (4/14 vs. 1/32; p=0.025). These observations may lead to the establishment of therapeutic guidelines according to the localization of the infarct.

Key words

childhood stroke - TCA/PVA complex - recurrence risk

References

• 1 Amlie-Lefond C, Sébire G, Fullerton HJ. Recent developments in childhood arterial ischaemic stroke.  Lancet Neurol. 2008;  7 425-435
• 2 Braun KP, Bulder MM, Chabrier S. et al . The course and outcome of unilateral intracranial arteriopathy in 79 children with ischaemic stroke.  Brain. 2009;  132 544-557
• 3 Chabrier S, Husson B, Lasjaunias P. et al . Stroke in childhood: outcome and recurrence risk by mechanism in 59 patients.  J Child Neurol. 2000;  15 290-294
• 4 Danchaivijitr N, Cox TC, Saunders DE. et al . Evolution of cerebral arteriopathies in childhood arterial ischemic stroke.  Ann Neurol. 2006;  59 620-626
• 5 Fullerton HJ, Johnston SC, Smith WS. Arterial dissection and stroke in children.  Neurology. 2002;  57 1155-1160
• 6 Fullerton HJ, Wu YW, Sidney S. et al . Risk of recurrent childhood arterial ischemic stroke in a population-based cohort: the importance of cerebrovascular imaging.  Pediatrics. 2007;  119 495-501
• 7 Ganesan VFJ, Chong WK, Cox TC. et al . Posterior circulation stroke in childhood: risk factor and recurrence.  Neurology. 2002;  59 1552-1556
• 8 Ganesan V, Prengler M, Wade A. et al . Clinical and radiological recurrence after childhood ischemic stroke.  Circulation. 2006;  114 2170-2177
• 9 Lanthier S, Armstrong D, Domi T. et al . Post-Varicella arteriopathy of childhood.  Natural history of vascular stenosis. Neurology. 2005;  64 660-663
• 10 Lanthier S, Carmant, David M. et al . Stroke in children: The coexistence of multiple risk factors predicts poor outcome.  Neurology. 2000;  54 371-378
• 11 Sébire G, Fullerton H, Riou E. et al . Toward the definition of cerebral arteriopathies of childhood.  Curr Opin Pediatr. 2004;  16 617-622
• 12 Wraige E, Pohl KR, Ganesan V. A proposed classification for subtypes of arterial ischaemic stroke in children.  Dev Med Child Neurol. 2005;  47 252-256

Correspondence