Skip to main content
Top
Published in: Child's Nervous System 2/2019

01-02-2019 | Original Paper

Arterial ischemic stroke (AIS) in childhood: clinical report from a single control center

Authors: Anna Portale, Agata Fiumara, Luisa Scalora, Filippo Greco, Pierluigi Smilari, Valeria Venti, Elena Pustorino, Piero Pavone

Published in: Child's Nervous System | Issue 2/2019

Login to get access

Abstract

Introduction

Stroke is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. It is the third cause of death in adults and one of the top 10 causes in pediatric age.
The perinatal period of onset is the second only to adult age group in the incidence of stroke. Arterial ischemic stroke during childhood occurs most frequently in the perinatal period with an incidence of 1 out 2300–5000 live infant births.

Materials and methods

This is a retrospective study that includes 28 patients affected by perinatal arterial ischemic stroke. Family and gestational history, risk factors of perinatal stroke, gender and clinical data of affected children and outcome are reported.

Results

A stroke family history was registered in three unrelated families. Gestational history disclosed cases of threats of abortion, preterm delivery, hyperthermia, gestosis, and placental disorders. In the children, onset of seizures were reported within 3 days of life and diagnosis of stroke was confirmed by brain MRI which disclosed involvement of the middle cerebral artery in all the cases. Hemilateral cerebral palsy, epileptic seizures, and intellectual disability from mild to severe were the most frequent complications.

Conclusion

Stroke is still a common and dreadful events in perinatal period as this disorder is often unpredictable and cause of severe neurological impairment.
Literature
1.
go back to reference Lehman LL, Rivkin MJ (2014) Perinatal arterial ischemic stroke: presentation, risk factors, evaluation and outcome. Pediatr Neurol 51(6):760–768CrossRefPubMed Lehman LL, Rivkin MJ (2014) Perinatal arterial ischemic stroke: presentation, risk factors, evaluation and outcome. Pediatr Neurol 51(6):760–768CrossRefPubMed
2.
go back to reference Lee J, Croen LA, Backstrand KH et al (2005) Maternal and infant characteristics associated with perinatal arterial stroke in the infant. JAMA 293:723–729CrossRefPubMed Lee J, Croen LA, Backstrand KH et al (2005) Maternal and infant characteristics associated with perinatal arterial stroke in the infant. JAMA 293:723–729CrossRefPubMed
3.
go back to reference Raju TNK, Nelson KB, Ferriero D, Lynch JK (2007) Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics 120:609–616CrossRefPubMed Raju TNK, Nelson KB, Ferriero D, Lynch JK (2007) Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics 120:609–616CrossRefPubMed
4.
go back to reference Lynch JK, Hirtz DG, deVeber G, Nelson KB (2002) Report of the National Institute of Neurological Disorders and Stroke workshop on perinatal and childhood stroke. Pediatrics 109:116–123CrossRefPubMed Lynch JK, Hirtz DG, deVeber G, Nelson KB (2002) Report of the National Institute of Neurological Disorders and Stroke workshop on perinatal and childhood stroke. Pediatrics 109:116–123CrossRefPubMed
5.
go back to reference Grinnon ST, Miler K, Marler JR et al (2012) National Institute of neurological disorders and stroke common data element project-approach and methods. Clin Trials 9:322–329CrossRefPubMedPubMedCentral Grinnon ST, Miler K, Marler JR et al (2012) National Institute of neurological disorders and stroke common data element project-approach and methods. Clin Trials 9:322–329CrossRefPubMedPubMedCentral
7.
go back to reference Wu YW, Linda CE, Henning LH et al (2006) Neuroimmaging abnormalities in infants with congenital hemiparesis. Pediatr Neurol 35:191–196CrossRefPubMed Wu YW, Linda CE, Henning LH et al (2006) Neuroimmaging abnormalities in infants with congenital hemiparesis. Pediatr Neurol 35:191–196CrossRefPubMed
8.
go back to reference Osler W (1987) The cerebral palsies of children. Mac Keith Press. Blackwell Scientific Publications, Oxford Osler W (1987) The cerebral palsies of children. Mac Keith Press. Blackwell Scientific Publications, Oxford
9.
go back to reference Freud S (1968) Infantile cerebral paralysis. University of Miami Press, Coral Gables Freud S (1968) Infantile cerebral paralysis. University of Miami Press, Coral Gables
10.
11.
go back to reference Golomb MR, Fullerton H, Nowak-Gottl U, deVeber G (2009) International pediatric stroke study group. Male predominance in childhood ischemic stroke: findings from the international pediatric stroke study. Stroke 40:52–57CrossRefPubMed Golomb MR, Fullerton H, Nowak-Gottl U, deVeber G (2009) International pediatric stroke study group. Male predominance in childhood ischemic stroke: findings from the international pediatric stroke study. Stroke 40:52–57CrossRefPubMed
12.
go back to reference Silvey M, Carpenter SL (2013) Inherited thrombophilia in children. Curr Probl Pediatr Adolesc Health Care 43:163–168CrossRefPubMed Silvey M, Carpenter SL (2013) Inherited thrombophilia in children. Curr Probl Pediatr Adolesc Health Care 43:163–168CrossRefPubMed
13.
go back to reference Golomb MR, Dick PT, MacGregor DL, Curtis R et al (2004) Neonatal arterial ischemic stroke and cerebral sinovenous thrombosis are more commonly diagnosed in boys. J Child Neurol 19:493–497CrossRefPubMed Golomb MR, Dick PT, MacGregor DL, Curtis R et al (2004) Neonatal arterial ischemic stroke and cerebral sinovenous thrombosis are more commonly diagnosed in boys. J Child Neurol 19:493–497CrossRefPubMed
14.
go back to reference Darmercy-Stamboul V, Chantegret C, Ferdynus C et al (2012) Antenatal factors associated with perinatal arterial ischemic stroke. Stroke 43:2307–2312CrossRef Darmercy-Stamboul V, Chantegret C, Ferdynus C et al (2012) Antenatal factors associated with perinatal arterial ischemic stroke. Stroke 43:2307–2312CrossRef
15.
go back to reference Wu YW, March WM, Croen LA, Grether JK (2004) Perinatal stroke in children with motor impairment: a population-based study. Pediatrics 114:612–619CrossRefPubMed Wu YW, March WM, Croen LA, Grether JK (2004) Perinatal stroke in children with motor impairment: a population-based study. Pediatrics 114:612–619CrossRefPubMed
16.
go back to reference Golomb MR, MacGregor DL, Domi T et al (2001) Presumed pre- or perinatal arterial ischemic stroke: risk factors and outcome. Ann Neurol 50(2):163–168CrossRefPubMed Golomb MR, MacGregor DL, Domi T et al (2001) Presumed pre- or perinatal arterial ischemic stroke: risk factors and outcome. Ann Neurol 50(2):163–168CrossRefPubMed
17.
go back to reference Benders MJ, Groenendaal F, Uiterwaal CS et al (2007) Maternal and infant characteristics associated with perinatal arterial stroke in the preterm infant. Stroke 38:1759–1765CrossRefPubMed Benders MJ, Groenendaal F, Uiterwaal CS et al (2007) Maternal and infant characteristics associated with perinatal arterial stroke in the preterm infant. Stroke 38:1759–1765CrossRefPubMed
18.
go back to reference Harteman JC, Groenendal F, Kwee A et al (2012) Risk factors for perinatal arterial ischemic stroke in full-term infants: a case-control study. Arch Dis Child Fetal Neonatal Ed 97:411–416CrossRef Harteman JC, Groenendal F, Kwee A et al (2012) Risk factors for perinatal arterial ischemic stroke in full-term infants: a case-control study. Arch Dis Child Fetal Neonatal Ed 97:411–416CrossRef
19.
go back to reference Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, Ferriero D, Jones BV, Kirkham FJ, Scott RM, Smith ER, American Heart Association Stroke Council, Council on Cardiovascular Disease in the Young (2008) Management of stroke in infants and children: a scientific statement from a special writing group of the American Hearth Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 39:2644–2691CrossRefPubMed Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, Ferriero D, Jones BV, Kirkham FJ, Scott RM, Smith ER, American Heart Association Stroke Council, Council on Cardiovascular Disease in the Young (2008) Management of stroke in infants and children: a scientific statement from a special writing group of the American Hearth Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 39:2644–2691CrossRefPubMed
20.
21.
go back to reference Gunther G, Junker R, Strater R et al (2000) Symptomatic ischemic stroke in full-term neonates: role of acquired and genetic prothrombotic risk factors. Stroke 31:2437–2441CrossRefPubMed Gunther G, Junker R, Strater R et al (2000) Symptomatic ischemic stroke in full-term neonates: role of acquired and genetic prothrombotic risk factors. Stroke 31:2437–2441CrossRefPubMed
22.
go back to reference Mercuri E, Cowan F, Gupte G, Manning R, Laffan M, Rutherford M, Edwards AD, Dubowitz L, Roberts I (2001) Prothrombotic disorders and abormal neurodevelopmental outcome in infants with neonatal cerebral infarction. Pediatrics 107:1400–1404CrossRefPubMed Mercuri E, Cowan F, Gupte G, Manning R, Laffan M, Rutherford M, Edwards AD, Dubowitz L, Roberts I (2001) Prothrombotic disorders and abormal neurodevelopmental outcome in infants with neonatal cerebral infarction. Pediatrics 107:1400–1404CrossRefPubMed
23.
go back to reference Suppiej A, Franzoi M, Gentilomo C et al (2008) High prevalence of inherited thrombophilia in ‘presumed peri-neonatal’ ischemic stroke. Eur J Haematol 80:71–75PubMed Suppiej A, Franzoi M, Gentilomo C et al (2008) High prevalence of inherited thrombophilia in ‘presumed peri-neonatal’ ischemic stroke. Eur J Haematol 80:71–75PubMed
24.
go back to reference Kocaman C, Yilmaz Y (2012) Etiological analysis of presumed perinatal stroke. Brain Dev 34:133–139CrossRefPubMed Kocaman C, Yilmaz Y (2012) Etiological analysis of presumed perinatal stroke. Brain Dev 34:133–139CrossRefPubMed
25.
go back to reference Del Balzo F, Spalice A, Ruggieri M, Greco F et al (2009) Stroke in children: inherited and acquired factors and age-related variations in the presentation of 48 paediatric patients. Acta Paediatr 98:1130–1136CrossRefPubMed Del Balzo F, Spalice A, Ruggieri M, Greco F et al (2009) Stroke in children: inherited and acquired factors and age-related variations in the presentation of 48 paediatric patients. Acta Paediatr 98:1130–1136CrossRefPubMed
26.
go back to reference Lynch JK, Han CJ, Nee LE, Nelson KB (2005) Prothrombotic factors in children with stroke or porencephaly. Pediatrics 116:447–453CrossRefPubMed Lynch JK, Han CJ, Nee LE, Nelson KB (2005) Prothrombotic factors in children with stroke or porencephaly. Pediatrics 116:447–453CrossRefPubMed
27.
go back to reference Rook JL, Nugent DJ, Young G (2005) Pediatric stroke and methylenetetrahydrofolate reductase polymorphisms: an examination of C677T and A1298C mutations. J Pediatr Hematol Oncol 27:590–593CrossRefPubMed Rook JL, Nugent DJ, Young G (2005) Pediatric stroke and methylenetetrahydrofolate reductase polymorphisms: an examination of C677T and A1298C mutations. J Pediatr Hematol Oncol 27:590–593CrossRefPubMed
28.
go back to reference De Moerloose P, Boehlen F (2007) Inherited thrombophilia in arterial disease: a selective revue. Semin Hematol 44:106–113CrossRefPubMed De Moerloose P, Boehlen F (2007) Inherited thrombophilia in arterial disease: a selective revue. Semin Hematol 44:106–113CrossRefPubMed
29.
go back to reference Monagle P, Chalmers E, Chan A et al (2008) Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-based Clinical Practice Guideline (8th edition). Chest 133:887S–968SCrossRef Monagle P, Chalmers E, Chan A et al (2008) Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-based Clinical Practice Guideline (8th edition). Chest 133:887S–968SCrossRef
30.
go back to reference Saxonhouse MA, Manco-Jhonson MJ (2009) The evaluation and management of neonatal coagulation disorders. Semin Perinatol 33:52–65CrossRefPubMed Saxonhouse MA, Manco-Jhonson MJ (2009) The evaluation and management of neonatal coagulation disorders. Semin Perinatol 33:52–65CrossRefPubMed
32.
go back to reference Lehman LL, Khoury JC, Taylor JM, Yeramaneni S, Sucharew H, Alwell K, Moomaw CJ, Peariso K, Flaherty M, Khatri P, Broderick JP, Kissela BM, Kleindorfer DO (2018) Pediatric stroke rates over 17 years: report from a population-based study. J Child Neurol 33(7):463–467 Lehman LL, Khoury JC, Taylor JM, Yeramaneni S, Sucharew H, Alwell K, Moomaw CJ, Peariso K, Flaherty M, Khatri P, Broderick JP, Kissela BM, Kleindorfer DO (2018) Pediatric stroke rates over 17 years: report from a population-based study. J Child Neurol 33(7):463–467
Metadata
Title
Arterial ischemic stroke (AIS) in childhood: clinical report from a single control center
Authors
Anna Portale
Agata Fiumara
Luisa Scalora
Filippo Greco
Pierluigi Smilari
Valeria Venti
Elena Pustorino
Piero Pavone
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 2/2019
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-018-4017-1

Other articles of this Issue 2/2019

Child's Nervous System 2/2019 Go to the issue