Neuroimaging in childhood arterial ischaemic stroke: evaluation of imaging modalities and aetiologies.
OBJECTIVE
The aim of this study was to describe neuroimaging patterns associated with arterial ischaemic stroke (AIS) in childhood and to differentiate them according to stroke aetiology.


METHODS
Clinical and neuroimaging (acute and follow-up) findings were analysed prospectively in 79 children (48 males, 31 females) aged 2 months to 15 years 8 months (median 5 y 3 mo) at the time of stroke by the Swiss Neuropaediatric Stroke Registry from 2000 to 2006.


RESULTS
Stroke was confirmed in the acute period in 36 out of 41 children who underwent computed tomography, in 53 of 57 who underwent T2-weighted magnetic resonance imaging (MRI) and in all 48 children who underwent diffusion-weighted MRI. AIS occurred in the anterior cerebral artery (ACA) in 63 participants and in all cases was associated with lesions of the middle cerebral artery (MCA). The lesion was cortical-subcortical in 30 out of 63 children, cortical in 25 out of 63, and subcortical in 8 of 63 children. Among participants with AIS in the posterior circulation territory, the stroke was cortical-subcortical in 8 out of 16, cortical in 5 of 16, and thalamic in 3 out of 16 children.


CONCLUSIONS
AIS mainly involves the anterior circulation territory, with both the ACA and the MCA being affected. The classification of Ganesan is an appropriate population-based classification for our Swiss cohort, but the neuroimaging pattern alone is insufficient to determine the aetiology of stroke in a paediatric population. The results show a poor correlation between lesion pattern and aetiology.
Buerki
Sarah
S
University Children's Hospital Berne, Switzerland.
Roellin
Katja
K
Remonda
Luca
L
Mercati
Danielle Gubser
DG
Jeannet
Pierre-Yves
PY
Keller
Elmar
E
Luetschg
Juerg
J
Menache
Caroline
C
Ramelli
Gian Paolo
GP
Schmitt-Mechelke
Thomas
T
Weissert
Markus
M
Boltshauser
Eugen
E
Steinlin
Maja
M
D000293:Adolescent; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D020765:Intracranial Arterial Diseases / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology*