Single-center series of boys with recurrent strokes and rotational vertebral arteriopathy.

Neurology
Christine K FoxNalin Gupta

Abstract

To describe a pediatric stroke syndrome with chronic focal vertebral arteriopathy adjacent to cervical abnormalities. At a single pediatric stroke center, we identified consecutive children with stroke and vertebral arteriopathy of the V3 segment with adjacent cervical bony or soft tissue abnormalities. We abstracted clinical presentation, treatment, and follow-up data from medical charts. From 2005 to 2019, 10 children (all boys, ages 6-16 years) presented with posterior circulation strokes and vertebral arteriopathy with adjacent cervical pathology. Two children had bony abnormalities: one had a congenital arcuate foramen and one had os odontoideum with cervical instability. In children without bony pathology, vertebral artery narrowing during contralateral head rotation was visualized by digital subtraction angiography. Eight boys had recurrent ischemic events despite anti-thrombotic treatment (including 5 with multiple recurrences) and were treated surgically to prevent additional stroke. Procedures included vertebral artery decompression (n = 6), endovascular stent and spinal fusion (n = 1), and vertebral artery endovascular occlusion (n = 1). In boys treated with decompression, cervical soft tissue abnormalities (ruptured...Continue Reading

References

Sep 2, 2003·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·M FukudaT Ozawa
Sep 13, 2008·Stroke; a Journal of Cerebral Circulation·Meredith R GolombUNKNOWN International Pediatric Stroke Study Group
Oct 21, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Hansel M GreinerMario Zuccarello
Jul 15, 2015·Journal of Pediatric Neurosciences·H S NandishA K Mahapatra
Mar 2, 2017·Stroke; a Journal of Cerebral Circulation·Nancy RollinsMichael Dowling
Feb 26, 2019·JAMA Neurology·Hugh S MarkusUNKNOWN Cervical Artery Dissection in Stroke Study (CADISS) Investigators

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Citations

Nov 7, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Bruno P BragaMichael M Dowling
Aug 1, 2021·The Lancet Child & Adolescent Health·Peter B SpornsMoritz Wildgruber

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