Advertisement

Child's Nervous System

, Volume 35, Issue 2, pp 283–293 | Cite as

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

  • Anna Portale
  • Agata Fiumara
  • Luisa Scalora
  • Filippo Greco
  • Pierluigi Smilari
  • Valeria Venti
  • Elena Pustorino
  • Piero PavoneEmail author
Original Paper
  • 137 Downloads

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.

Keywords

Stroke Seizures Neurological impairment Cerebral palsy 

Notes

Acknowledgements

The authors wish to thank American Manuscript Editors (USA) for editing the manuscript. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Compliance with ethical standards

Conflicts of interest

There are no conflicts of interest.

References

  1. 1.
    Lehman LL, Rivkin MJ (2014) Perinatal arterial ischemic stroke: presentation, risk factors, evaluation and outcome. Pediatr Neurol 51(6):760–768CrossRefGoogle Scholar
  2. 2.
    Lee J, Croen LA, Backstrand KH et al (2005) Maternal and infant characteristics associated with perinatal arterial stroke in the infant. JAMA 293:723–729CrossRefGoogle Scholar
  3. 3.
    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 120:609–616CrossRefGoogle Scholar
  4. 4.
    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 109:116–123CrossRefGoogle Scholar
  5. 5.
    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 9:322–329CrossRefGoogle Scholar
  6. 6.
    Nelson KB, Lynch JK (2004) Stroke in newborn infants. Lancet Neurol 3:150–158CrossRefGoogle Scholar
  7. 7.
    Wu YW, Linda CE, Henning LH et al (2006) Neuroimmaging abnormalities in infants with congenital hemiparesis. Pediatr Neurol 35:191–196CrossRefGoogle Scholar
  8. 8.
    Osler W (1987) The cerebral palsies of children. Mac Keith Press. Blackwell Scientific Publications, OxfordGoogle Scholar
  9. 9.
    Freud S (1968) Infantile cerebral paralysis. University of Miami Press, Coral GablesGoogle Scholar
  10. 10.
    Bremme KA (2003) Haemostatic changes in pregnancy. Best Pract Res Clin Haematol 16:153–168CrossRefGoogle Scholar
  11. 11.
    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 40:52–57CrossRefGoogle Scholar
  12. 12.
    Silvey M, Carpenter SL (2013) Inherited thrombophilia in children. Curr Probl Pediatr Adolesc Health Care 43:163–168CrossRefGoogle Scholar
  13. 13.
    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 19:493–497CrossRefGoogle Scholar
  14. 14.
    Darmercy-Stamboul V, Chantegret C, Ferdynus C et al (2012) Antenatal factors associated with perinatal arterial ischemic stroke. Stroke 43:2307–2312CrossRefGoogle Scholar
  15. 15.
    Wu YW, March WM, Croen LA, Grether JK (2004) Perinatal stroke in children with motor impairment: a population-based study. Pediatrics 114:612–619CrossRefGoogle Scholar
  16. 16.
    Golomb MR, MacGregor DL, Domi T et al (2001) Presumed pre- or perinatal arterial ischemic stroke: risk factors and outcome. Ann Neurol 50(2):163–168CrossRefGoogle Scholar
  17. 17.
    Benders MJ, Groenendaal F, Uiterwaal CS et al (2007) Maternal and infant characteristics associated with perinatal arterial stroke in the preterm infant. Stroke 38:1759–1765CrossRefGoogle Scholar
  18. 18.
    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 97:411–416CrossRefGoogle Scholar
  19. 19.
    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 39:2644–2691CrossRefGoogle Scholar
  20. 20.
    Jaigobin C, Silver FL (2000) Stroke and pregnancy. Stroke 31:2948–2951CrossRefGoogle Scholar
  21. 21.
    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 31:2437–2441CrossRefGoogle Scholar
  22. 22.
    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 107:1400–1404CrossRefGoogle Scholar
  23. 23.
    Suppiej A, Franzoi M, Gentilomo C et al (2008) High prevalence of inherited thrombophilia in ‘presumed peri-neonatal’ ischemic stroke. Eur J Haematol 80:71–75Google Scholar
  24. 24.
    Kocaman C, Yilmaz Y (2012) Etiological analysis of presumed perinatal stroke. Brain Dev 34:133–139CrossRefGoogle Scholar
  25. 25.
    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 98:1130–1136CrossRefGoogle Scholar
  26. 26.
    Lynch JK, Han CJ, Nee LE, Nelson KB (2005) Prothrombotic factors in children with stroke or porencephaly. Pediatrics 116:447–453CrossRefGoogle Scholar
  27. 27.
    Rook JL, Nugent DJ, Young G (2005) Pediatric stroke and methylenetetrahydrofolate reductase polymorphisms: an examination of C677T and A1298C mutations. J Pediatr Hematol Oncol 27:590–593CrossRefGoogle Scholar
  28. 28.
    De Moerloose P, Boehlen F (2007) Inherited thrombophilia in arterial disease: a selective revue. Semin Hematol 44:106–113CrossRefGoogle Scholar
  29. 29.
    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–968SCrossRefGoogle Scholar
  30. 30.
    Saxonhouse MA, Manco-Jhonson MJ (2009) The evaluation and management of neonatal coagulation disorders. Semin Perinatol 33:52–65CrossRefGoogle Scholar
  31. 31.
    Callaghan WM, MacDorman MF, Shapiro-Mendoza CK, Barfield WD (2017) Explaining the recent decrease in US infant mortality rate, 2007–2013. Am J Obstet Gynecol 216(1):73.e1–73.e8.  https://doi.org/10.1016/j.ajog.2016.09.097
  32. 32.
    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):463–467Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatrics, AOU Policlinico-Vittorio EmanueleUniversity of CataniaCataniaItaly

Personalised recommendations