Skip to main content
SpringerLink
Log in

Arterial ischemic stroke in children - Recent advances

  • Symposium on Neurological Disorders - Advances in Management
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Childhood stroke syndromes are an important cause of mortality and morbidity. This paper focuses on the recent advances in arterial ischaemic stroke beyond the neonatal period. Vascular risk factors are identified in the majority of children and guide both acute and longer term treatments, as well as determining prognosis. Contrary to popular belief many children have residual impairments encompassing a wide range of domains. National and international collaborations are facilitating an increase in the understanding of childhood stroke and have the eventual aim of conducting trials of potential therapeutic interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mackay J, Mensah GA. The atlas of heart disease and stroke Geneva: World Health Organization, 2004.

    Google Scholar 

  2. Rosamond W, Flegal K, Furie K et al. Heart disease and stroke statistics-2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008; 117:e25–e146.

    PubMed  Google Scholar 

  3. Ganesan V, Hogan A, Shack N. Outcome after ischaemic stroke in childhood. Dev Med Child Neurol 2000;42:455–461.

    PubMed  CAS  Google Scholar 

  4. de Veber GA, MacGregor D, Curtis R, Mayank S. Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis. J Child Neurol 2000;15:316–324.

    Google Scholar 

  5. Strater R, Becker S, von Eckardstein A et al. Prospective assessment of risk factors for recurrent stroke during childhood-a 5-year follow-up study. Lancet 2002; 360: 1540–1545.

    PubMed  Google Scholar 

  6. Fullerton HJ, Wu YW, Sidney S, Johnston SC. Recurrent hemorrhagic stroke in children: a population-based cohort study. Stroke 2007;38: 2658–662.

    PubMed  Google Scholar 

  7. Lo W, Zamel K, Ponnappa K et al. The cost of pediatric stroke care and rehabilitation. Stroke 2008;39:161–165.

    PubMed  Google Scholar 

  8. Ganesan V, Prengler M, McShane MA, Wade AM, Kirkham FJ. Investigation of risk factors in children with arterial ischemic stroke. Ann Neurol 2003;53:167–173.

    PubMed  Google Scholar 

  9. DeVeber G. The Canadian Pediatric Ischemic Stroke Study Group: Canadian paediatric ischemic stroke registry: analysis of children with arterial ischemic stroke [abstract]. Ann Neurol 2000;48:526.

    Google Scholar 

  10. Fullerton HJ, Wu YW, Zhao S, Johnston SC. Risk of stroke in children: ethnic and gender disparities. Neurology 2003;61:189–194.

    PubMed  Google Scholar 

  11. Williams AN, Eunson PD, McShane MA, Lynn R, Green SH, Kirkham F. Childhood cerebrovascular disease and stroke like illness in the United Kingdom and Eire. A descriptive epidemiological study. Arch Dis Child 2002; 86(Suppl 1):A40–A41 (G113).

    Google Scholar 

  12. Shi KL, Wang JJ, Li JW et al. Arterial Ischemic Stroke: Experience in Chinese Children. Pediatr Neurol 2008; 38: 186–190.

    PubMed  Google Scholar 

  13. Lee YY, Lin KL, Wang HS et al. Risk factors and outcomes of childhood ischemic stroke in Taiwan. Brain Dev 2008; 30: 14–19.

    PubMed  Google Scholar 

  14. McGlennan C, Ganesan V. Delays in investigation and management of acute arterial ischaemic stroke in children. Dev Med Child Neurol 2008; 50: 537–540.

    PubMed  Google Scholar 

  15. Gabis LV, Yangala R, Lenn NJ. Time lag to diagnosis of stroke in children. Pediatrics 2002; 110: 924–928.

    PubMed  Google Scholar 

  16. Braun KP, Kappelle LJ, Kirkham FJ, Deveber G. Diagnostic pitfalls in paediatric ischaemic stroke. Dev Med Child Neurol 2006; 48: 985–990.

    PubMed  Google Scholar 

  17. Zimmer JA, Garg BP, Williams LS, Golomb MR. Agerelated variation in presenting signs of childhood arterial ischemic stroke. Pediatr Neurol 2007; 37: 171–175.

    PubMed  Google Scholar 

  18. Braun KP, Rafay MF, Uiterwaal CS, Pontigon AM, DeVeber G. Mode of onset predicts etiological diagnosis of arterial ischemic stroke in children. Stroke 2007;38: 298–302.

    PubMed  Google Scholar 

  19. Fullerton HJ, Wu YW, Sidney S, Johnston SC. Risk of recurrent childhood arterial ischemic stroke in a populationbased cohort: the importance of cerebrovascular imaging. Pediatrics 2007;119: 495–501.

    PubMed  Google Scholar 

  20. de Veber G. Stroke and the child’s brain: an overview of epidemiology, syndromes and risk factors. Curr Opin Neurol 2002;15:133–138.

    Google Scholar 

  21. DeVeber G. Risk factors for childhood stroke: little folks have different strokes! Ann Neurol 2003;53:149–150.

    PubMed  Google Scholar 

  22. Nowak-Gottl U, Gunther G, Kurnik K, Strater R, Kirkham F. Arterial ischemic stroke in neonates, infants, and children: an overview of underlying conditions, imaging methods, and treatment modalities. Semin Thromb Hemost 2003;29:405–414.

    PubMed  Google Scholar 

  23. Canadian Paediatric Ischemic Stroke Study Group. Arterial Ischemic Stroke in Canadian Children. Ann Neurol 2006;60:S115.

    Google Scholar 

  24. Danchaivijitr N, Cox TC, Saunders DE, Ganesan V. Evolution of cerebral arteriopathies in childhood arterial ischemic stroke. Ann Neurol 2006;59:620–626.

    PubMed  Google Scholar 

  25. Paediatric Stroke Working Group. Stroke in childhood: clinical guidelines for diagnosis, management and rehabilitation,2004. http://www.rcplondon.ac.uk/pubs/books/childstroke/ (Accessed 18 January 2008)

  26. Sebire G, Fullerton H, Riou E, de Veber G. Toward the definition of cerebral arteriopathies of childhood. Curr Opin Pediatr 2004;16:617–622.

    PubMed  Google Scholar 

  27. Sebire G. Transient cerebral arteriopathy in childhood. Lancet 2006;368:8–10.

    PubMed  Google Scholar 

  28. Sebire G, Meyer L, Chabrier S. Varicella as a risk factor for cerebral infarction in childhood: a case-control study. Ann Neurol 1999;45:679–680.

    PubMed  CAS  Google Scholar 

  29. Askalan R, Laughlin S, Mayank S et al. Chickenpox and stroke in childhood: a study of frequency and causation. Stroke 2001;32:1257–1262.

    PubMed  CAS  Google Scholar 

  30. Lanthier S, Armstrong D, Domi T, de Veber G. Post-varicella arteriopathy of childhood: natural history of vascular stenosis. Neurology 2005;64:660–663.

    PubMed  Google Scholar 

  31. von Scheven E, Lee C, Berg BO. Pediatric Wegener’s granulomatosis complicated by central nervous system vasculitis. Pediatr Neurol 1998;19:317–319.

    Google Scholar 

  32. Nagra A, Saleem MA, Ramanan AV. The disease with a thousand faces. Arch. Dis. Child. Ed. Pract. 2006;91:ep14-.

    Google Scholar 

  33. Cantu C, Pineda C, Barinagarrementeria F, et al. Noninvasive cerebrovascular assessment of Takayasu arteritis. Stroke 2000;31:2197–2202.

    PubMed  CAS  Google Scholar 

  34. Benseler S, Schneider R. Central nervous system vasculitis in children. Curr Opin Rheumatol 2004;16:43–50.

    PubMed  Google Scholar 

  35. Elbers J, Benseler SM. Central nervous system vasculitis in children. Curr Opin Rheumatol 2008;20:47–54.

    PubMed  Google Scholar 

  36. Aviv RI, Benseler SM, Silverman ED et al. MR imaging and angiography of primary CNS vasculitis of childhood. AJNR Am J Neuroradiol 2006;27:192–199.

    PubMed  CAS  Google Scholar 

  37. Miravet E, Danchaivijitr N, Basu H, Saunders DE, Ganesan V. Clinical and radiological features of childhood cerebral infarction following varicella zoster virus infection. Dev Med Child Neurol 2007;49:417–422.

    PubMed  Google Scholar 

  38. Benseler SM, Silverman E, Aviv RI et al. Primary central nervous system vasculitis in children. Arthritis Rheum 2006;54:1291–1297.

    PubMed  Google Scholar 

  39. Benseler SM, de Veber G, Hawkins C et al. Angiographynegative primary central nervous system vasculitis in children: a newly recognized inflammatory central nervous system disease. Arthritis Rheum 2005;52:2159–2167.

    PubMed  Google Scholar 

  40. Monagle P, Chan A, Massicotte P, Chalmers E, Michelson AD. Antithrombotic Therapy in Children: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126:645S–687S.

    PubMed  CAS  Google Scholar 

  41. Fung LW, Thompson D, Ganesan V. Revascularisation surgery for paediatric moyamoya: a review of the literature. Childs Nerv Syst 2005;21:358–364.

    PubMed  Google Scholar 

  42. Dobson SR, Holden KR, Nietert PJ et al. Moyamoya syndrome in childhood sickle cell disease: a predictive factor for recurrent cerebrovascular events. Blood 2002;99:3144–3150.

    PubMed  CAS  Google Scholar 

  43. Hankinson TC, Bohman LE, Heyer G et al. Surgical treatment of moyamoya syndrome in patients with sickle cell anemia: outcome following encephaloduroarteriosynangiosis. J Neurosurg Pediatrics 2008; 1: 211–216.

    PubMed  Google Scholar 

  44. Tripathi P, Tripathi V, Naik RJ, Patel JM. Moya Moya cases treated with encephaloduroarteriosynangiosis. Indian Pediatr 2007;44:123–127.

    PubMed  Google Scholar 

  45. Steinlin M, Pfister I, Pavlovic J et al. The first three years of the Swiss Neuropaediatric Stroke Registry (SNPSR): a population-based study of incidence, symptoms and risk factors. Neuropediatrics 2005; 36: 90–97.

    PubMed  CAS  Google Scholar 

  46. Kirkham F, Sebire G, Steinlin M, Strater R. Arterial ischaemic stroke in children. Review of the literature and strategies for future stroke studies. Thromb Haemost 2004; 92: 697–706.

    PubMed  CAS  Google Scholar 

  47. Kirton A, DeVeber G. Ischemic stroke complicating pediatric cardiovascular disease. Nat Clin Pract Cardiovasc Med 2007;4:163–166.

    PubMed  Google Scholar 

  48. Latson LA. Patent foramen ovale - “back door” to the brain, even in kids. Catheter Cardiovasc Interv 2007; 70: 1008–1009.

    PubMed  Google Scholar 

  49. Kenny D, Turner M, Martin R. When to close a patent foramen ovale. Arch Dis Child 2008; 93: 255–259.

    PubMed  CAS  Google Scholar 

  50. Sakurai K, Horiuchi Y, Ikeda H et al. A novel susceptibility locus for moyamoya disease on chromosome 8q23. J Hum Genet 2004;49:278–281.

    PubMed  CAS  Google Scholar 

  51. Mineharu Y, Liu W, Inoue K et al. Autosomal dominant moyamoya disease maps to chromosome 17q25.3. Neurology 2008; 70: 2357–2363.

    PubMed  CAS  Google Scholar 

  52. Chou HF, Liang WC, Zhang Q, Goto Y, Jong YJ. Clinical and genetic features in a MELAS child with a 3271T>C mutation. Pediatr Neurol 2008; 38: 143–146.

    PubMed  Google Scholar 

  53. Fan H, Civalier C, Booker JK, Gulley ML, Prior TW, Farber RA. Detection of common disease-causing mutations in mitochondrial DNA (mitochondrial encephalomyopathy, lactic acidosis with stroke-like episodes MTTL1 3243 A>G and myoclonic epilepsy associated with ragged-red fibers MTTK 8344A>G) by real-time polymerase chain reaction. J Mol Diagn 2006;8:277–281.

    PubMed  CAS  Google Scholar 

  54. Voetsch B, Jin RC, Bierl C et al. Promoter polymorphisms in the plasma glutathione peroxidase (GPx-3) gene: a novel risk factor for arterial ischemic stroke among young adults and children. Stroke 2007;38:41–49.

    PubMed  CAS  Google Scholar 

  55. Voetsch B, Jin RC, Bierl C et al. Role of promoter polymorphisms in the plasma glutathione peroxidase (GPx-3) gene as a risk factor for cerebral venous thrombosis. Stroke 2008;39:303–307.

    PubMed  CAS  Google Scholar 

  56. Hoppe C, Klitz W, Cheng S et al. Gene interactions and stroke risk in children with sickle cell anemia. Blood 2004;103:2391–2396.

    PubMed  CAS  Google Scholar 

  57. Hoppe C, Klitz W, D’Harlingue K et al. Confirmation of an association between the TNF(-308) promoter polymorphism and stroke risk in children with sickle cell anemia. Stroke 2007;38:2241–2246.

    PubMed  CAS  Google Scholar 

  58. Sebastiani P, Ramoni MF, Nolan V, Baldwin CT, Steinberg MH. Genetic dissection and prognostic modeling of overt stroke in sickle cell anemia. Nat Genet 2005;37:435–440.

    PubMed  CAS  Google Scholar 

  59. Desmond DW, Moroney JT, Lynch T, Chan S, Chin SS, Mohr JP. The natural history of CADASIL: a pooled analysis of previously published cases. Stroke 1999;30:1230–1233.

    PubMed  CAS  Google Scholar 

  60. Fattapposta F, Restuccia R, Pirro C et al. Early diagnosis in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL): the role of MRI. Funct Neurol 2004;19:239–242.

    PubMed  Google Scholar 

  61. Breedveld G, de Coo IF, Lequin MH et al. Novel mutations in three families confirm a major role of COL4A1 in hereditary porencephaly. J Med Genet 2006;43:490–495.

    PubMed  CAS  Google Scholar 

  62. Gould DB, Phalan FC, van Mil SE et al. Role of COL4A1 in small-vessel disease and hemorrhagic stroke. N Engl J Med 2006;354:1489–1496.

    PubMed  CAS  Google Scholar 

  63. Rolfs A, Bottcher T, Zschiesche M et al. Prevalence of Fabry disease in patients with cryptogenic stroke: a prospective study. Lancet 2005;366:1794–1796.

    PubMed  Google Scholar 

  64. Grange DK, Balfour IC, Chen SC, Wood EG. Familial syndrome of progressive arterial occlusive disease consistent with fibromuscular dysplasia, hypertension, congenital cardiac defects, bone fragility, brachysyndactyly, and learning disabilities. Am J Med Genet 1998;75:469–480.

    PubMed  CAS  Google Scholar 

  65. Cartwright MS, Hickling WH, Roach ES. Ischemic stroke in an adolescent with arterial tortuosity syndrome. Neurology 2006; 67: 360–361.

    PubMed  Google Scholar 

  66. Heyer GL, Dowling MM, Licht DJ et al. The cerebral vasculopathy of PHACES syndrome. Stroke 2008; 39: 308–316.

    PubMed  Google Scholar 

  67. Gunny RS, Cox T, Ganesan V. Cervical arterial pathology in children with acute arterial ischaemic stroke. Dev Med Child Neurol 2006;48:S42.

    Google Scholar 

  68. Hankins JS, Fortner GL, McCarville MB et al. The natural history of conditional transcranial Doppler flow velocities in children with sickle cell anaemia. Br J Haematol 2008;142:94–99.

    PubMed  Google Scholar 

  69. McCarville MB, Goodin GS, Fortner G et al. Evaluation of a comprehensive transcranial doppler screening program for children with sickle cell anemia. Pediatr Blood Cancer 2008; 50: 818–821.

    PubMed  Google Scholar 

  70. Liu M. Stroke: encouragement and disappointment in clinical trials. Lancet Neurol 2008; 7: 5–7.

    PubMed  CAS  Google Scholar 

  71. DeVeber G. In pursuit of evidence-based treatments for paediatric stroke: the UK and Chest guidelines. Lancet Neurol 2005;4:432–436.

    PubMed  Google Scholar 

  72. Hacke W, Donnan G, Fieschi C et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004;363:768–774.

    PubMed  Google Scholar 

  73. Alexandrov AV. Can the therapeutic window for tissue plasminogen activator be extended to 6 hours after stroke onset? Nat Clin Pract Cardiovasc Med 2005; 2: 342–343.

    PubMed  Google Scholar 

  74. Janjua N, Nasar A, Lynch JK, Qureshi AI. Thrombolysis for ischemic stroke in children: data from the nationwide inpatient sample. Stroke 2007; 38: 1850–1854.

    PubMed  Google Scholar 

  75. Lo EH. Experimental models, neurovascular mechanisms and translational issues in stroke research. Br J Pharmacol 2008;153 Suppl 1:S396–405.

    PubMed  CAS  Google Scholar 

  76. Fuentes B, Diez-Tejedor E. General care in stroke: relevance of glycemia and blood pressure levels. Cerebrovasc Dis 2007;24 Suppl 1:134–142.

    PubMed  Google Scholar 

  77. Diez-Tejedor E, Fuentes B. Homeostasis as basis of acute stroke treatment: stroke units are the key. Cerebrovasc Dis 2005;20 Suppl 2:129–134.

    PubMed  Google Scholar 

  78. Leira R, Blanco M, Rodriguez-Yanez M, Flores J, Garcia-Garcia J. Non-pharmacological neuroprotection: role of emergency stroke management. Cerebrovasc Dis 2006;21 Suppl 2:89–98.

    PubMed  Google Scholar 

  79. Adams HP, Jr., del Zoppo G, Alberts MJ et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation 2007;115:e478–534.

    PubMed  Google Scholar 

  80. Sacco RL, Adams R, Albers G et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: cosponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Circulation 2006;113:e409–449.

    PubMed  Google Scholar 

  81. Bernard TJ, Goldenberg NA, Armstrong-Wells J, Amlie-Lefond C, Fullerton HJ. Treatment of childhood arterial ischemic stroke. Ann Neurol 2008; 63: 679–696.

    PubMed  Google Scholar 

  82. Castillo J, Leira R, Garcia MM, Serena J, Blanco M, Davalos A. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke 2004; 35: 520–526.

    PubMed  Google Scholar 

  83. Oliveira-Filho J, Silva SC, Trabuco CC, Pedreira BB, Sousa EU, Bacellar A. Detrimental effect of blood pressure reduction in the first 24 hours of acute stroke onset. Neurology 2003; 61: 1047–1051.

    PubMed  CAS  Google Scholar 

  84. Faustino EV, Apkon M. Persistent hyperglycemia in critically ill children. J Pediatr 2005; 146: 30–34.

    PubMed  Google Scholar 

  85. Adams RJ, McKie VC, Hsu L et al. Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography. N Engl J Med 1998; 339: 5–11.

    PubMed  CAS  Google Scholar 

  86. Fullerton HJ, Adams RJ, Zhao S, Johnston SC. Declining stroke rates in Californian children with sickle cell disease. Blood 2004; 104: 336–339.

    PubMed  CAS  Google Scholar 

  87. The Optimizing Primary Stroke Prevention in Sickle Cell Anemia (STOP 2) Trial Investigators. Discontinuing Prophylactic Transfusions Used to Prevent Stroke in Sickle Cell Disease. N Engl J Med 2005; 353: 2769–2778.

    Google Scholar 

  88. Zimmerman SA, Schultz WH, Burgett S, Mortier NA, Ware RE. Hydroxyurea therapy lowers transcranial Doppler flow velocities in children with sickle cell anemia. Blood 2007; 110: 1043–1047.

    PubMed  CAS  Google Scholar 

  89. Mazumdar M, Heeney MM, Sox CM, Lieu TA. Preventing stroke among children with sickle cell anemia: an analysis of strategies that involve transcranial Doppler testing and chronic transfusion. Pediatrics 2007; 120: e1107–1116.

    PubMed  Google Scholar 

  90. Pegelow CH, Adams RJ, McKie V et al. Risk of recurrent stroke in patients with sickle cell disease treated with erythrocyte transfusions. J Pediatr 1995; 126: 896–899.

    PubMed  CAS  Google Scholar 

  91. Fryer RH, Anderson RC, Chiriboga CA, Feldstein NA. Sickle cell anemia with moyamoya disease: outcomes after EDAS procedure. Pediatr Neurol 2003; 29: 124–130.

    PubMed  Google Scholar 

  92. Ware RE, Zimmerman SA, Sylvestre PB et al. Prevention of secondary stroke and resolution of transfusional iron overload in children with sickle cell anemia using hydroxyurea and phlebotomy. J Pediatr 2004;145:346–352.

    PubMed  CAS  Google Scholar 

  93. Lanthier S, Carmant L, David M, Larbrisseau A, de Veber G. Stroke in children: the coexistence of multiple risk factors predicts poor outcome. Neurology 2000;54:371–378.

    PubMed  CAS  Google Scholar 

  94. Ganesan V, Prengler M, Wade A, Kirkham FJ. Clinical and radiological recurrence after childhood arterial ischemic stroke. Circulation 2006; 114: 2170–2177.

    PubMed  Google Scholar 

  95. Gold JI, Johnson CB, Treadwell MJ, Hans N, Vichinsky E. Detection and assessment of stroke in patients with sickle cell disease: neuropsychological functioning and magnetic resonance imaging. Pediatr Hematol Oncol 2008; 25: 409–421.

    PubMed  Google Scholar 

  96. Fullerton HJ, Chetkovich DM, Wu YW, Smith WS, Johnston SC. Deaths from stroke in US children, 1979 to 1998. Neurology 2002; 59: 34–39.

    PubMed  CAS  Google Scholar 

  97. Jordan LC, van Beek JGM, Gottesman RF, Kossoff EH, Johnston MV. Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign. Pediatric Neurology 2007;36:244–246.

    PubMed  Google Scholar 

  98. Dusser A, Goutieres F, Aicardi J. Ischemic strokes in children. J Child Neurol 1986; 1: 131–136.

    PubMed  CAS  Google Scholar 

  99. Giroud M, Lemesle M, Madinier G, Manceau E, Osseby GV, Dumas R. Stroke in children under 16 years of age. Clinical and etiological difference with adults. Acta Neurol Scand 1997;96:401–406.

    PubMed  CAS  Google Scholar 

  100. Wolf SL, Lecraw DE, Barton LA, Jann BB. Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. Exp Neurol 1989; 104: 125–132.

    PubMed  CAS  Google Scholar 

  101. Gordon A, Connelly A, Neville B et al. Modified constraintinduced movement therapy after childhood stroke. Dev Med Child Neurol 2007; 49: 23–27.

    PubMed  Google Scholar 

  102. Hogan AM, Kirkham FJ, Isaacs EB. Intelligence after stroke in childhood: review of the literature and suggestions for future research. J Child Neurol 2000; 15: 325–332.

    PubMed  CAS  Google Scholar 

  103. Gout A, Seibel N, Rouviere C et al. Aphasia owing to subcortical brain infarcts in childhood. J Child Neurol 2005;20:1003–1008.

    PubMed  Google Scholar 

  104. Rowan A, Vargha-Khadem F, Calamante F et al. Cortical abnormalities and language function in young patients with basal ganglia stroke. Neuroimage 2007; 36: 431–440.

    PubMed  Google Scholar 

  105. Max JE, Mathews K, Manes FF et al. Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke. J Int Neuropsychol Soc 2003;9:815–829.

    PubMed  Google Scholar 

  106. Lansing AE, Max JE, Delis DC et al. Verbal learning and memory after childhood stroke. J Int Neuropsychol Soc 2004; 10: 742–752.

    PubMed  Google Scholar 

  107. Everts R, Pavlovic J, Kaufmann F et al. Cognitive functioning, behavior, and quality of life after stroke in childhood. Child Neuropsychol 2008; 14: 323–338.

    PubMed  Google Scholar 

  108. Pavlovic J, Kaufmann F, Boltshauser E et al. Neuropsychological problems after paediatric stroke: two year follow-up of Swiss children. Neuropediatrics 2006; 37: 13–19.

    PubMed  CAS  Google Scholar 

  109. Gordon AL, Ganesan V, Towell A, Kirkham FJ. Functional outcome following stroke in children. J Child Neurol 2002; 17: 429–434.

    PubMed  Google Scholar 

  110. International Paediatric Stroke Study. https://app3.ccb.sickkids.ca/cstrokestudy/ (Accessed 17/06/2008)

  111. Study of Outcome of Childhood Stroke. http://www.childstroke.org.uk (Accessed 17/06/2008)

Download references

Author information

Authors and Affiliations

  1. Institute of Child Life and Health University of Bristol, Bristol, London

    Andrew A. Mallick

  2. Neuroscience unit Institute of Child Health University College, Bristol, London

    Vijeya Ganesan

  3. Department of Pediatric Neurology, Great Ormond Street Hospital, London, WCIN 3JH, United Kingdom

    Vijeya Ganesan

Authors
  1. Andrew A. Mallick
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vijeya Ganesan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vijeya Ganesan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mallick, A.A., Ganesan, V. Arterial ischemic stroke in children - Recent advances. Indian J Pediatr 75, 1149–1157 (2008). https://doi.org/10.1007/S12098-008-0239-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/S12098-008-0239-7

Key words

Search

Navigation