Risk factors in childhood arterial ischaemic stroke: Findings from a population-based study in Germany |
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Authors: | Lucia Gerstl Raphael Weinberger Ruediger von Kries Florian Heinen A Sebastian Schroeder Michaela V Bonfert Ingo Borggraefe Moritz Tacke Katharina Vill Mirjam N Landgraf Karin Kurnik Martin Olivieri |
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Institution: | 1. Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children''s Hospital, Ludwig-Maximilians-University of Munich, Lindwurmstr. 4, 80337 Munich, Germany;2. Institute of Social Paediatrics and Adolescent Medicine, Division of Epidemiology, Ludwig-Maximilians-University Munich, Haydnstr. 5, 80336, Munich, Germany;3. Department of Paediatric Haemostaseolgy, Dr. von Hauner Children''s Hospital, Ludwig-Maximilians-University of Munich, Lindwurmstr. 4, 80337, Munich, Germany |
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Abstract: | ObjectiveAcute treatment of childhood arterial ischaemic stroke and prevention strategies for recurrent stroke episodes depend strongly on each child's individual risk profile. The aim of this study is to characterize risk factors for childhood stroke, their occurrence in isolation or combination, and to identify possible common risk factor patterns.MethodsThis population-based study was conducted via ESPED, a surveillance unit for rare paediatric diseases in Germany. Children aged >28days and <18 years with an acute arterial ischaemic stroke occurring between January 2015 and December 2016 were included.ResultsAmong 99 reported children with arterial ischaemic stroke, 56 children were male. Male predominance was significant in adolescents from 12 years old onward. Arterial ischaemic stroke was more common in very young children <2 years of age and in adolescence. No risk factor was identified in 27 children. Hypercoagulable states (29%), cardiac disorders (24%), and arteriopathies (21%) were the most common risk factors. Some risk factor categories were more likely to be identified in isolation (i.e. cardiac disorders, prothrombotic abnormalities and chronic head and neck disorders) than others. The number of risk factors (n = 0–4) per patient and risk factor categories did not differ by age.ConclusionAlthough we could not identify common patterns of risk factor combinations, several risk factors occurred more likely in isolation than others. Further research should focus on the impact of isolated presumed childhood stroke risk factors like certain prothrombotic abnormalities, migraine or a patent foramen ovale. With regard to different age groups, stroke mechanisms in male adolescents require particular attention. |
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Keywords: | Paediatric stroke Cerebrovascular disease Risk factor AIS arterial ischaemic stroke ESPED Erhebungseinheit für Seltene Pädiatrische Erkrankungen in Deutschland/German nation-wide Surveillance Unit for rare paediatric diseases PFO patent foramen ovale RTLS right to left shunt |
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