Early-onset bilateral cerebral arteriopathies: Cohort study of phenotype and disease course

Neurology
Amina Al-YassinV Ganesan

Abstract

To describe characteristics of young children with arterial ischemic stroke (AIS) and bilateral cerebral arteriopathies. Retrospective review of clinical features, course, and outcome. Neuroimaging was analyzed for infarct pattern, cerebrovascular diagnosis (anatomic/Childhood Arterial Ischemic Stroke Standardized Classification and Diagnostic Evaluation [CASCADE] criteria), and disease progression. In the 31 children (median age, 18 months), presentations included acute hemiparesis (n=23) and focal seizures (n=12). Seven had systemic arterial disease; 13 had cardiac abnormalities. Twenty had recurrent AIS or transient ischemic attack (after median of 3 months); 16 had >1 recurrence. Median modified Rankin Scale score was 3, with motor impairments in 20, cognitive impairments in 11, and seizures in 7. At presentation, 17 had old and acute infarcts. Twenty-five had high signal in white matter. A total of 13/23 reimaged patients accrued further infarcts over a median of 39 months. Arteriopathy involved the carotid circulation bilaterally in all; 6 had posterior circulation and 11 had extracranial involvement. Arteriopathy distribution was symmetric in 24/31. CASCADE categories were 3A in 19, 3B in 5, 3C in 5, and 7 in 2. After a ...Continue Reading

References

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Citations

Aug 7, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Mark T Mackay, Maja Steinlin
Mar 16, 2018·Stroke; a Journal of Cerebral Circulation·Arthur StaceyVijeya Ganesan
Feb 28, 2018·Neurology·Sara C Tho-CalviUNKNOWN British Paediatric Neurology Association Moyamoya Study group
Jan 29, 2019·Stroke; a Journal of Cerebral Circulation·Donna M FerrieroUNKNOWN American Heart Association Stroke Council and Council on Cardiovascular and Stroke Nursing
Sep 22, 2020·Brain Communications·Andrea RosiDarren B Orbach
May 11, 2021·Developmental Medicine and Child Neurology·Emily BlackburnVijeya Ganesan

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