Stroke in Middle Eastern children with cancer: prevalence and risk factors.


Journal

BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555

Informations de publication

Date de publication:
18 Jan 2022
Historique:
received: 22 10 2020
accepted: 13 01 2022
entrez: 19 1 2022
pubmed: 20 1 2022
medline: 21 1 2022
Statut: epublish

Résumé

To determine the prevalence and to characterize the different types of strokes in children with cancer at the Children's Cancer Center of Lebanon (CCCL), in addition to assess the factors and clinical findings leading to stroke in children. We retrospectively reviewed the medical records and brain images (MRIs and CTs) of children admitted to the CCCL and diagnosed with cancer between years 2008 and 2017. Brain images were reviewed for the strokes' onset, size, location, possible origin, its recurrence and type: intracranial hemorrhage (ICH), acute arterial ischemic stroke, and cerebral sinus venous thrombosis (CSVT) with and without venous infarct. Medical charts of the patients were reviewed for age, sex, their type of cancer, the treatment protocol they followed, and abnormal findings on their laboratory studies and neurological exams. Out of the 905 charts reviewed, twenty-seven children with variable types of cancer had strokes, with a prevalence of 2.9%. Their median age at cancer diagnosis was 9.4 (4.8-13.7) years and the median age at stroke onset was 10.6 (6.7-15.5) years. The median time between the cancer diagnosis and the stroke episode was 6 months. CSVT cases were the most common (60%) followed by acute arterial ischemic (22%) and hemorrhagic strokes (18%), with CSVT being the latest to occur. We observed that the different types of strokes were related to some types of cancer. Of the children that had acute arterial ischemic stroke in this cohort, 83% had brain tumors, of the children who had CSVT, 87.5% had leukemia, and of the children who had hemorrhagic stroke, 40% had leukemia. Neurological abnormalities were more prevalent in acute arterial ischemic stroke (80%). Patients with CSVT recovered better than those with other types of strokes. Strokes recurred in 60% of ischemic strokes. L-Asparaginase was significantly associated with CSVT. The prevalence of strokes was 2.9% in children with cancer. We were able to identify factors related to the types of the stroke that occurred in children including the type and location of the cancer the type of treatment received, and stroke recurrence.

Identifiants

pubmed: 35042459
doi: 10.1186/s12883-022-02556-x
pii: 10.1186/s12883-022-02556-x
pmc: PMC8764852
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

31

Informations de copyright

© 2022. The Author(s).

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Auteurs

Catherina Zadeh (C)

Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon.

Natally AlArab (N)

Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon.

Samar Muwakkit (S)

Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon.

Lamya A Atweh (LA)

Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon.

Hani Tamim (H)

Biostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.

Maha Makki (M)

Biostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.

Hamza A Salhab (HA)

Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon.

Roula Hourani (R)

Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon. rh64@aub.edu.lb.
Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon. rh64@aub.edu.lb.

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