Pediatric Stroke News Tips from the American Stroke Associations International Stroke Conference 2010

March 24, 2010

Although stroke occurs primarily in the elderly, it also strikes young adults, children, infants and can even occur before birth — and with equally devastating results.  Here is some of the latest research related to children and stroke.  Despite varying presentation times, all four abstracts have the same embargo release time: 2 p.m. CT, Wednesday, Feb. 24, 2010. 

For more background, see the American Heart Association/American Stroke Associations’ fact sheet on pediatric stroke.

Abstract 57 – Childhood stroke may have distinctive risk factors
Clot-related strokes in children may have a distinctive risk factor profile, said researchers from the International Pediatric Stroke Study group. Of 676 children from 29 days to 18 years old, researchers identified stroke risk factors in 91 percent.  Some children had multiple factors including:

  • Arteriopathy (disease of the arteries such as anatomical abnormalities) – 53 percent;
  • Cardiac disorders – 31 percent;
  • Chronic systemic conditions – 30 percent;
  • Infection – 24 percent;
  • Acute head and neck disorders – 23 percent;
  • Acute systemic conditions – 22 percent;
  • Prothrombotic states (having a condition that predisposes the patient to developing a clot or obstruction of circulation) – 13 percent;
  • Chronic head and neck disorders – 10 percent;
  • Atherosclerosis, or fatty build up inside arteries – 2 percent ; and
  • Other risk factors – 22 percent.

The study’s findings highlight the importance of vascular imaging to detect diseases of the arteries, researchers said. Mark T. Mackay, M.B., B.S., Department of Neurology, Royal Children’s Hospital, Melbourne VIC, Australia; (613) 934-5566, extension 1; mark.mackay@rch.org.au.

Abstract 58 – Odds of stroke are six times greater in children with congenital heart disease; those who require heart surgery are at greater risk
A study of 2.3 million children under age 20 found a six-fold increase in the odds of a stroke for those born with a malformed heart. Congenital heart disease is a well known and important risk factor for childhood stroke; however, estimates of relative stroke risk are lacking.  The study, which included children enrolled in a Northern California managed care plan between 1993 and 2004, also showed that stroke risk increased around the time of a heart operation and lingered somewhat after surgery.  The increased risk in children who require a corrective heart surgery may be explained in part because these children tend to have more severe heart disease. 

The study documented 370 cases of childhood stroke.  Of the 11 children who had surgery to repair a heart defect, five had a stroke within two weeks of the operation, one stroke occurred a month later and four strokes happened six to 18 years post surgery. Christine K. Fox, M.D., University of California, San Francisco; (415) 476-2027; foxc@neuropeds.ucsf.edu.
Note: Actual presentation is 2:12 p.m. CT

Abstract 61 – Children who have stroke caused by blockage at risk for more strokes
A child who has an ischemic stroke is at risk of another soon after, according to a study.
In a study of 93 children (average age 5.8 years old) treated for stroke between June 2003 and June 2009, researchers found that 12 had additional strokes — most occurring within about a month of initial stroke symptoms. 

In six of the children with recurrent strokes, the initial stroke was not diagnosed until the time of the recurrence. Because of the prevalence of additional strokes after an initial, undiagnosed stroke, researchers said the study highlighted the dangers of missed or delayed diagnosis, and the need for improving early detection and developing effective preventive treatments. Rebeccca N. Ichord, M.D., Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine; (215) 590-4142; ichord@email.chop.edu.
Note: Actual presentation is 2:48 p.m. CT

Abstract 62 – High body mass index linked to rare form of stroke in children
In a small study of 23 children, researchers found that high body mass index (BMI) is a risk factor for cerebral sinus venous thrombosis (CVST), a rare, serious form of stroke.  Investigators said counseling on better nutrition might help prevent this type of stroke in children.

Researchers examined almost two dozen youth diagnosed with CSVT from March 2006 to August 2009.  They compared the weight of the children with CSVT to a control group of hospitalized children without the disease who were the same age and gender. 

The study found that 57 percent of those with CSVT were overweight, compared to 25 percent of the control group. Virginia Pearson, M.S., University of Colorado School of Medicine; (305) 793-7339; Virginia.pearson@ucdenver.edu.
Note: Actual presentation is 3 p.m. CT

Author disclosures are on the abstracts.

Click here to download audio clips offering perspective on this research from American Stroke Association spokesperson Steve Roach, M.D., Chief of the Division of Child Neurology, an attending physician at both Nationwide Children’s Hospital and the Ohio State University Medical Center; also a Professor of Pediatrics and Neurology at The Ohio State University College of Medicine, Columbus Ohio.

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report ‘s 2018-19 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.4 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.