title: The utility of infarct volume measurement in pediatric ischemic stroke.
abstract: This study aims to determine if stroke volume as measured on diffusion-weighted imaging is associated with neurologic outcome in children with acute arterial ischemic stroke. A cohort of patients presenting to a tertiary care children's hospital with acute ischemic stroke were studied. The relationship between stroke volume, clinical characteristics, and neurologic outcome utilizing the Glasgow Outcome Scale were analyzed. In children with poor outcome, the median volume of infarction on diffusion-weighted imaging was larger when compared with children who had a good outcome. Children with stroke volume >10% of total brain volume were more likely than patients with stroke volume <5% total brain volume to have a poor outcome. Seizures were associated with a 10.5-fold increase in the risk of a poor outcome. Stroke volume, in conjunction with clinical characteristics, can assist practitioners in identifying a subset of patients with acute ischemic stroke who might benefit from aggressive medical and/or surgical management.
authors.affiliation: Georgetown University School of Medicine, Department of Pediatrics, Washington, DC, USA Nassim.Zecavati@gunet.georgetown.edu.
authors.forename: Nassim
authors.initials: N
authors.lastname: Zecavati
authors.affiliation: University of Michigan, Department of Pediatrics, Ann Arbor, MI, USA.
authors.forename: Rani
authors.initials: R
authors.lastname: Singh
authors.affiliation: Georgetown University School of Medicine, Department of Pediatrics, Washington, DC, USA.
authors.forename: Raquel
authors.initials: R
authors.lastname: Farias-Moeller
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Cara
authors.initials: C
authors.lastname: Olsen
authors.affiliation: Children's National Medical Center, Center for Neuroscience, Washington, DC, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Carpenter
authors.affiliation: Children's National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC, USA.
authors.forename: Nadja
authors.initials: N
authors.lastname: Kadom
mesh_terms: D000293:Adolescent; D020520:Brain Infarction / Q000209:etiology* / Q000473:pathology*; D002545:Brain Ischemia / Q000150:complications; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology
keywords: pediatric stroke; stroke outcome; stroke volume