Ischemic Stroke in Children

Dear Colleagues,

The occurrence of arterial ischemic stroke (AIS) in children is undoubtedly a serious medical problem. AIS results from a multifactorial background in both children and in adults. However, etiologic mechanisms of childhood AIS differ from those observed in adulthood stroke. Particular attention, both in terms of the occurrence of the first incident of cerebral ischemia and possible recurrences in children, should be paid to the arteriopathy of cerebral vessels, especially focal cerebral arteriopathy of childhood (FCA). Genetic risk factors may be also involved in childhood AIS etiology, as indicated by the age of patients. Moreover, the importance of genetic factors in the etiology of stroke in pediatric patients has been confirmed by studies carried out among pairs of monozygotic twins, in which stroke occurred almost five times more often than in twin dizygotic pairs. Previously, several meta-analyses of our authorship regarding the role of particular genetic polymorphisms in the development of childhood AIS were conducted. The obtained results indicated that MTHFR 677C>T and FII 20210G>A polymorphisms may be considered as risk factors for the disease in pediatric patients. In addition, non-genetic risk factors, including mainly biochemical ones, are of great interest, whereas environmental factors (which are common in adults) seem to have low or no clinical relevance in children. From the perspective of the pathophysiology of AIS, interactions between existing risk factors may also play a significant role.

Although the incidence of cerebrovascular-disease-related deaths of pediatric patients has decreased over the past decade, these diseases—including AIS—remain among the most common causes of child death in developed countries. The consequences of childhood stroke, such as epilepsy, permanent physical disability and aphasia, as well as retardation of psychomotor development, are at the root of disability and carry the huge costs associated with many years of care, rehabilitation, and treatment. Thus, knowing the predictors of poor post-stroke outcome is of great relevance.

Although there is more and more data available on the risk factors related to the occurrence of AIS and its consequences, in many children suffering from AIS no cause of the disease is being determined. Establishing the predictors (clinical, metabolic, or genetic) which increase the risk of stroke in children may be helpful in building strategies for secondary prevention. This makes any new report in the field valuable.

In this Special Issue we would like to welcome articles, including original research, reviews, meta-analyses, or case studies, which address the scope of ischemic stroke in children.

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• arterial ischemic stroke
• children
• pediatric
• childhood stroke
• cerebral infarction
• recurrent stroke
• risk factors
• predictors