Anticoagulation in childhood-onset arterial ischemic stroke with nonmoyamoya arteriopathy: Findings from the Colorado and German (COAG) collaboration

Timothy J. Bernard, Neil A. Goldenberg, Mark Tripputi, Marilyn J. Manco-Johnson, Thomas Niederstadt, Ulrike Nowak-Göttl

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND AND PURPOSE-: Childhood arterial ischemic stroke treatment guidelines recommend extended anticoagulation in cardioembolism and dissection. We sought to investigate the safety of extended anticoagulation in childhood arterial ischemic stroke with nonmoyamoya arteriopathy, for which the risk of recurrent stroke is high. METHODS-: Thirty-seven patients with childhood-onset arterial ischemic stroke with acute arteriopathy (excluding moyamoya) were diagnosed between 1999 and 2007 and treated with anticoagulation for at least 4 weeks. Patients were followed in hospital-based cohort studies at 2 centers and systematically assessed for bleeding episodes and recurrent events. RESULTS-: Over a cumulative anticoagulation duration of 1329 patient-months, there were no major bleeding episodes and 2 clinically relevant bleeding episodes. Cumulative probability of recurrent arterial ischemic stroke at 1 year was 14%. CONCLUSIONS-: Anticoagulation can be used safely for secondary arterial ischemic stroke prevention in children with acute nonmoyamoya arteriopathy. Anticoagulation is worthy of evaluation in future randomized, controlled treatment trials in this disease.

Original languageEnglish (US)
Pages (from-to)2869-2871
Number of pages3
JournalStroke
Volume40
Issue number8
DOIs
StatePublished - Aug 2009
Externally publishedYes

Keywords

  • Anticoagulation
  • Arteriopathy
  • Childhood stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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