Neuroimaging in childhood arterial ischaemic stroke: evaluation of imaging modalities and aetiologies
Article first published online: 30 APR 2010
© The Authors. Journal compilation © Mac Keith Press 2010
Developmental Medicine & Child Neurology
Volume 52, Issue 11, pages 1033–1037, November 2010
How to Cite
BUERKI, S., ROELLIN, K., REMONDA, L., MERCATI, D. G., JEANNET, P.-Y., KELLER, E., LUETSCHG, J., MENACHE, C., RAMELLI, G. P., SCHMITT-MECHELKE, T., WEISSERT, M., BOLTSHAUSER, E. and STEINLIN, M. (2010), Neuroimaging in childhood arterial ischaemic stroke: evaluation of imaging modalities and aetiologies. Developmental Medicine & Child Neurology, 52: 1033–1037. doi: 10.1111/j.1469-8749.2010.03685.x
- Issue published online: 30 APR 2010
- Article first published online: 30 APR 2010
- Accepted for publication 2nd March 2010. Published online 30th April 2010.
Aim The aim of this study was to describe neuroimaging patterns associated with arterial ischaemic stroke (AIS) in childhood and to differentiate them according to stroke aetiology.
Method Clinical and neuroimaging (acute and follow-up) findings were analysed prospectively in 79 children (48 males, 31 females) aged 2 months to 15 years 8 months (median 5y 3mo) at the time of stroke by the Swiss Neuropaediatric Stroke Registry from 2000 to 2006.
Results Stroke was confirmed in the acute period in 36 out of 41 children who underwent computed tomography, in 53 of 57 who underwent T2-weighted magnetic resonance imaging (MRI) and in all 48 children who underwent diffusion-weighted MRI. AIS occurred in the anterior cerebral artery (ACA) in 63 participants and in all cases was associated with lesions of the middle cerebral artery (MCA). The lesion was cortical–subcortical in 30 out of 63 children, cortical in 25 out of 63, and subcortical in 8 of 63 children. Among participants with AIS in the posterior circulation territory, the stroke was cortical–subcortical in 8 out of 16, cortical in 5 of 16, and thalamic in 3 out of 16 children.
Interpretation AIS mainly involves the anterior circulation territory, with both the ACA and the MCA being affected. The classification of Ganesan is an appropriate population-based classification for our Swiss cohort, but the neuroimaging pattern alone is insufficient to determine the aetiology of stroke in a paediatric population. The results show a poor correlation between lesion pattern and aetiology.