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Arterial ischaemic stroke in children Review of the literature and strategies for future stroke studies

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
Topic:

Paediatric Haemostasis

DOI: http://dx.doi.org/10.1160/TH04-04-0209
Issue: 2004: 92/4 (Oct) pp. 672-895
Pages: 697-706

Arterial ischaemic stroke in children Review of the literature and strategies for future stroke studies

Fenella Kirkham1, Guillaume Sébire2, Maja Steinlin3, Ronald Sträter4*

1Neurosciences Unit, Institute of Child Health, University College London, and University of Southampton, United Kingdom 2Service de Neurologie Pédiatrique, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium 3Divisio

Summary

Conditions associated with arterial ischaemic stroke in children include a great variety of diseases and triggers such as congenital heart malformations, sickle cell disease, infections and vasculopathies, although up to 50% are cryptogenic. An abnormal vascular status can be demonstrated by vascular imaging in up to 80% of children with ischaemic stroke, and case control studies demonstrate an association between ischaemic stroke in children and hereditary prothrombotic risk factors and infections such as Varicella. Conventional risk factors such as hyper tension and dyslipidaemia may also play a role, and most children have several potential triggers rather than one single cause. This review focuses on clinical presentations, imaging methods, stroke subtypes, underlying conditions including prothrombotic risk factors, outcome and recurrence. Although data from randomised controlled trials, on which clinical practice might be based, are sparse, therapeutic approaches and future research directions are discussed.