Ischemic Stroke in Children

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (20 November 2021) | Viewed by 13674

Special Issue Editors


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Guest Editor
Department of Basic Biomedical Science, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia in Katowice, 41–200 Sosnowiec, Poland
Interests: genetic, biochemical and clinical risk factors for cerebrovascular diseases in children; arterial ischemic stroke; post-stroke consequences; epilepsy; headache; cerebral palsy; modern drug forms (liposomes, nanoparticles)
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Guest Editor
Department of Pediatric Neurology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
Interests: cerebrovascular disorders; arterial ischemic stroke; risk factors; headache; thrombophilia; arteriopathy; cerebral palsy; epilepsy; congenital brain malformations; rare diseases; children
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

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.

Dr. Beata Sarecka-Hujar
Dr. Ilona Kopyta
Guest Editors

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Keywords

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

Published Papers (3 papers)

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Editorial

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3 pages, 184 KiB  
Editorial
Introduction to the Special Issue on Ischemic Stroke in Children
by Beata Sarecka-Hujar and Ilona Kopyta
Children 2022, 9(6), 832; https://doi.org/10.3390/children9060832 - 3 Jun 2022
Cited by 1 | Viewed by 1102
Abstract
The occurrence of arterial ischemic stroke (AIS) is a serious medical problem due to the deleterious neurological consequences that affect the daily functioning of the patient as well as the costs of medical care and rehabilitation [...] Full article
(This article belongs to the Special Issue Ischemic Stroke in Children)

Research

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10 pages, 1106 KiB  
Article
Multimodal Treatment of Pediatric Ruptured Brain Arteriovenous Malformations: A Single-Center Study
by Lukasz Antkowiak, Monika Putz, Marta Rogalska and Marek Mandera
Children 2021, 8(3), 215; https://doi.org/10.3390/children8030215 - 11 Mar 2021
Cited by 4 | Viewed by 1881
Abstract
Bleeding from ruptured brain arteriovenous malformations (bAVMs) represents the most prevalent cause of pediatric intracranial hemorrhage, being also the most common initial bAVM manifestation. A therapeutic approach in these patients should aim at preventing rebleeding and associated significant morbidity and mortality. The purpose [...] Read more.
Bleeding from ruptured brain arteriovenous malformations (bAVMs) represents the most prevalent cause of pediatric intracranial hemorrhage, being also the most common initial bAVM manifestation. A therapeutic approach in these patients should aim at preventing rebleeding and associated significant morbidity and mortality. The purpose of this study was to determine the clinical outcomes of pediatric patients who initially presented at our institution with ruptured bAVMs and to review our experience with a multimodality approach in the management of pediatric ruptured bAVMs. We retrospectively reviewed pediatric patients’ medical records with ruptured bAVMs who underwent interventional treatment (microsurgery, embolization, or radiosurgery; solely or in combination) at our institution between 2011 and 2020. We identified 22 patients. There was no intraoperative and postoperative intervention-related mortality. Neither procedure-related complications nor rebleeding were observed after interventional treatment. Modified Rankin Scale (mRS) assessment at discharge revealed 19 patients (86.4%) with favorable outcomes (mRS 0–2) and 3 patients (13.6%) classified as disabled (mRS 3). Microsurgery ensured the complete obliteration in all patients whose postoperative digital subtraction angiography (DSA) was available. Management of high-grade bAVMs with radiosurgery or embolization can provide satisfactory outcomes without a high disability risk. Full article
(This article belongs to the Special Issue Ischemic Stroke in Children)
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Review

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11 pages, 612 KiB  
Review
Pediatric Patient with Ischemic Stroke: Initial Approach and Early Management
by Jozef Klučka, Eva Klabusayová, Tereza Musilová, Tereza Kramplová, Tamara Skříšovská, Milan Kratochvíl, Martina Kosinová, Ondřej Horák, Hana Ošlejšková, Petr Jabandžiev and Petr Štourač
Children 2021, 8(8), 649; https://doi.org/10.3390/children8080649 - 28 Jul 2021
Cited by 6 | Viewed by 5791
Abstract
Acute Ischemic Stroke (AIS) in children is an acute neurologic emergency associated with significant morbidity and mortality. Although the incidence of AIS in pediatric patients is considerably lower than in adults, the overall cumulative negative impact of the quality of life could be [...] Read more.
Acute Ischemic Stroke (AIS) in children is an acute neurologic emergency associated with significant morbidity and mortality. Although the incidence of AIS in pediatric patients is considerably lower than in adults, the overall cumulative negative impact of the quality of life could be even higher in children. The age-related variable clinical presentation could result in a delay in diagnosis and could negatively influence the overall outcome. The early management should be based on early recognition, acute transfer to pediatric AIS centre, standardised approach (ABCDE), early neurologic examination together with neuroimaging (preferable Magnetic Resonance Imaging—MRI). The treatment is based on supportive therapy (normoxemia, normocapnia, normotension and normoglycemia) in combination with intravenous/intraarterial thrombolytic therapy and/or mechanical thrombectomy in selected cases. Pediatric stroke centres, together with the implementation of local stroke management protocols, could further improve the outcome of pediatric patients with AIS. Full article
(This article belongs to the Special Issue Ischemic Stroke in Children)
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