Childhood arterial ischemic stroke: A review of etiologies, antithrombotic treatments, prognostic factors, and priorities for future research

Courtney A. Lyle, Timothy J. Bernard, Neil A. Goldenberg

Research output: Contribution to journalReview article

Abstract

Childhood arterial ischemic stroke (AIS) is a rare, but serious, medical condition, which is fatal in approximately 3% and associated with both acute and long-term neurologic impairment in over 70% of cases. Common etiologies include sickle cell disease, congenital heart disease, arterial dissection, prothrombotic conditions, and preceding viral infections; however, one in four cases is considered idiopathic. To date, no randomized controlled clinical trials (RCTs) have been conducted to establish evidence for current therapeutic strategies outside of sickle cell disease, thus, treatment strategies are largely shaped by consensus-based guidelines, in which, beyond the acute period, aspirin is the mainstay of therapy and anticoagulation is reserved for select circumstances. In recent years, evidence on prognostic factors has accumulated, helping to inform the future design of prognostically stratified RCTs. In this narrative review, we discuss the current understanding of etiologies, consensus-based treatment recommendations, contemporary treatment data, and prognostic factors in childhood AIS. We also identify priorities for future research.

Original languageEnglish (US)
Pages (from-to)786-793
Number of pages8
JournalSeminars in Thrombosis and Hemostasis
Volume37
Issue number7
DOIs
StatePublished - 2011
Externally publishedYes

Keywords

  • Childhood arterial ischemic stroke
  • pediatric stroke

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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