Investigation of Risk Factors in Children with Arterial Ischemic Stroke

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Investigation of Risk Factors in Children with Arterial Ischemic Stroke
Ann Neurol 53:167-173,149, Ganesan,V.,et al, 2003 See this aricle in Pubmed

Article Abstract
We present data on the known risk factors encountered in children presenting with a first arterial ischemic stroke to a single tertiary center over 22 years. Two hundred twelve patients (54% male; median age, 5 years) were identified. One hundred fifteen (54%) were previously healthy. Cerebral arterial imaging was undertaken in 185 patients (87%) and was abnormal in 79%. O f104 previously healthy patients investigated with echocardiography, only 8 had abnormal studies. Genetic or acquir ed conditions causing thrombophilia were rare. Forty percent of patients were anemic, and 21% either had elevated total plasma homocysteine or were homozygous for the t-MTHFR mutation. Trauma and previous varicella zoster infection were significantly mo re common in the previously healthy group. There was a significant association between cerebral arterial abnormalities and systolic blood pressure greater than 90th percentile and a trend for an association with varicella within the previous year. Clini cal history and examination usually identify underlying risk factors and precipitating triggers for arterial ischemic stroke in childhood. Cerebral arterial imaging is usually abnormal, but echocardiography and prothrombotic screening are commonly negati ve.

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