Risk factors and outcomes of childhood ischemic stroke in Taiwan.
In this retrospective study, we reviewed the charts and collected clinical and radiographic data on children (age range, 1 month to 18 years) with symptoms and radiographic confirmation of ischemic stroke for the period of January 1996 to July 2006. Ninety-four children were enrolled. Eighty-eight had arterial ischemic stroke and six had sinovenous thrombosis. Twenty-nine percent of the children had seizures. Twenty-six percent had diffuse neurological signs and 76% had focal neurological signs. Risk factors included vascular disease (33%), infection (27%), metabolic disorders (18%), trauma (11%), prothrombotic states (13%), cardiac disease (10%), and mitochondrial disease (6%). Ten percent (n=9) had no identifiable cause. Twenty-two percent of the children had more than one risk factor. Anterior territory (70%) was more involved than posterior territory (18%) in arterial ischemic stroke. Unilateral infarctions were more common on the left side (51%) than on the right (24.5%). Neurological deficits were present in 45% (n=34/75) of the children; the most frequent deficit was motor impairment (24%). Seven children (9%) died in the acute stage. There were 12 children (16%) who had recurrent stroke and 8 children (8/12) who had underlying vascular disease. The vascular disease included moyamoya disease (5), CNS lupus (1) and ill-defined vasculopathy (2). The etiology pattern in Taiwan was different from that in Western countries. Vascular disease was a significant risk factor for recurrence in childhood ischemic stroke.
Lee
Ying-Ying
YY
Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Lin
Kuang-Lin
KL
Wang
Huei-Shyong
HS
Chou
Min-Liang
ML
Hung
Po-Cheng
PC
Hsieh
Meng-Ying
MY
Lin
Jainn-Jim
JJ
Wong
Alex Mun-Ching
AM
D000293:Adolescent; D000367:Age Factors; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D020520:Brain Infarction / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D002545:Brain Ischemia / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D005843:Geography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D013624:Taiwan / Q000453:epidemiology; D014652:Vascular Diseases / Q000453:epidemiology