Abstract Number: PB1296
Meeting: ISTH 2020 Congress
Background: Childhood arterial ischemic stroke (AIS) is a rare but serious event.
Aims: To investigate the clinical background of the childhood AIS in a reference Thrombosis Centre in Greece.
Methods: Data were retrospectively collected for children aged 28 days-18 years old with AIS referred between 2009 and 2019. Patients with cancer or CVL related AIS were excluded from the study.
Results: Overall, 48 children were reported [mean age: 7.5±4.4 years, 54.5% males]. Most children (85%) presented with focal symptoms, including hemiparesis (67%), speech disturbances (29%) and facial weakness (23%), but also with headache (31%), convulsions (31%) and loss of consciousness (29%). Diagnosis was based on MRI/MRA (53%), followed by CT. Affected vessels were middle cerebral artery (46%), carotid (14.6%), basilar (8.3%) and anterior cerebral artery (6.2%). Dissection was confirmed in 10.4%. Lateralization was right in most cases, followed by left side in 40% and both sides in 8.3%. Transient ischaemic attack was assumed in 10.4%.
Trauma (27%), infection (18.8%), cardiac disorders (18.8%), arteriopathies (16.6%) and prothrombotic states (12.5%) were the most frequently identified risk factors, while a quarter had no apparent underlying cause. Heterozygosity for FVLeiden and FII20210A mutations and homozygosity for MTHFR-C776T were found in 4.5%, 5% and 10.9% of patients respectively, without statistical significance.
The majority of children (98%) were discharged home (rehabilitation clinic: 2%). At time of discharge most common neurological symptoms were hemiparesis (35%) and speech disturbances (16.6%), while 31% of children had no neurological sequelae. Almost three quarters of patients received anticoagulation (42% aspirin, 15% warfarin, 15% warfarin and then aspirin), while 56% received anticoagulation for >2 years. After long-term follow up, 46% had no neurological residual, 8% had attention deficits and 8% cognitive decline. No child died.
Conclusions: This study provides population-based data for childhood AIS, which may be useful for further research.
To cite this abstract in AMA style:Dettoraki A, Michalopoulou A, Ioannidou L, Komitopoulou A, Gavra M, Xafaki P, Kapsimali Z, Pergantou H. Arterial Ischemic Stroke in Greek Infants, Children and Adolescents: a Single-Centre Experience [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/arterial-ischemic-stroke-in-greek-infants-children-and-adolescents-a-single-centre-experience/. Accessed May 6, 2021.
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