MedWire News: Children with stroke are most likely to have cerebral arteriopathies if they are of early school age, have sickle cell disease, or a recent upper respiratory tract infection, reports the International Pediatric Stroke Study Group.
The group encompasses 30 centers in five continents. For the current study, Heather Fullerton (University of California, San Francisco, USA) and colleagues report on 667 children aged between 29 days and 19 years.
Of these children, 525 (81%) had vascular imaging data, which revealed an arteriopathy in 277 (53%). Children were less likely to undergo imaging if they presented without focal deficits.
The most common arteriopathy was idiopathic focal cerebral arteriopathy of childhood (FCA), which accounted for 25% of arteriopathies, followed by moyamoya, present in 22%, and arterial dissection, present in 20% of children with arteriopathies.
Other arteriopathies included vasculitis, arteriopathy related to sickle cell disease, and postvaricella angiopathy.
Compared with children aged between 29 days and 4 years, the likelihood of having arteriopathies was elevated 2.04 fold in those aged 5–9 years, but was not elevated in children aged 10–14 years or 15–19 years.
Children were 3.06 times more likely to have arteriopathies if they had sickle cell disease and 2.36 times more likely if they had a recent upper respiratory tract infection, after accounting for confounders.
Upper respiratory tract infection was the only independent predictor of FCA, the researchers report in the journal Circulation.
In an accompanying editorial, M Patricia Massicotte and Jerome Yager from Stollery Children’s Hospital in Edmonton, Alberta, Canada, noted that the prevalence of arteriopathy in children with stroke may have been underestimated, given that 9% of the study cohort did not undergo vascular imaging.
“The importance [of the study] lies in identifying those children most likely to experience recurrence and indicating the subsequent need for further studies determining the safety and efficacy of secondary prophylaxis,” they said.
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