Inflammatory Type Focal Cerebral Arteriopathy of the Posterior Circulation in Children: A Comparative Cohort Study.

carotid artery, internal constriction, pathologic ischemic stroke posterior cerebral artery stroke

Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
06 Mar 2024
Historique:
medline: 6 3 2024
pubmed: 6 3 2024
entrez: 6 3 2024
Statut: aheadofprint

Résumé

Inflammatory type focal cerebral arteriopathy (FCA-i) in the anterior circulation (AC) is well characterized, and the focal cerebral arteriopathy severity score (FCASS) reflects the severity of the disease. We identified cases of FCA-i in the posterior circulation (PC) and adapted the FCASS to describe these cases. In this comparative cohort study, patients from the Swiss NeuroPaediatric Stroke Registry with ischemic stroke due to FCA-i between January 2000 and December 2018 were analyzed. A comparison between PC and AC cases regarding pediatric National Institutes of Health Stroke Scale score and pediatric stroke outcome measure and FCASS was performed. We estimated infarct size by the modified pediatric Alberta Stroke Program Early Computed Tomography Score in children with AC stroke and the adapted Bernese posterior diffusion-weighted imaging score in the PC. Thirty-five children with a median age of 6.3 (interquartile range, 2.7-8.2 [95% CI, 0.9-15.6]; 20 male; 57.1%) years with FCA-i were identified. The total incidence rate was 0.15/100 000/year (95% CI, 0.11-0.21). Six had PC-FCA-i. Time to final FCASS was longer in the PC compared with AC; the evolution of FCASS did not differ. Initial pediatric National Institutes of Health Stroke Scale score was higher in children with FCA-i in the PC with a median of 10.0 (interquartile range, 5.75-21.0) compared with 4.5 (interquartile range, 2.0-8.0) in those with AC-FCA-i. Different from the anterior cases, PC infarct volume did not correlate with higher discharge, maximum, or final FCASS scores (Pearson correlation coefficient [r], 0.25, 0.35, and 0.54). FCA-i also affects the PC. These cases should be included in future investigations into FCA-i. Although it did not correlate with clinical outcomes in our cohort, the modified FCASS may well serve as a marker for the evolution of the arteriopathy in posterior FCA-i.

Sections du résumé

BACKGROUND UNASSIGNED
Inflammatory type focal cerebral arteriopathy (FCA-i) in the anterior circulation (AC) is well characterized, and the focal cerebral arteriopathy severity score (FCASS) reflects the severity of the disease. We identified cases of FCA-i in the posterior circulation (PC) and adapted the FCASS to describe these cases.
METHODS UNASSIGNED
In this comparative cohort study, patients from the Swiss NeuroPaediatric Stroke Registry with ischemic stroke due to FCA-i between January 2000 and December 2018 were analyzed. A comparison between PC and AC cases regarding pediatric National Institutes of Health Stroke Scale score and pediatric stroke outcome measure and FCASS was performed. We estimated infarct size by the modified pediatric Alberta Stroke Program Early Computed Tomography Score in children with AC stroke and the adapted Bernese posterior diffusion-weighted imaging score in the PC.
RESULTS UNASSIGNED
Thirty-five children with a median age of 6.3 (interquartile range, 2.7-8.2 [95% CI, 0.9-15.6]; 20 male; 57.1%) years with FCA-i were identified. The total incidence rate was 0.15/100 000/year (95% CI, 0.11-0.21). Six had PC-FCA-i. Time to final FCASS was longer in the PC compared with AC; the evolution of FCASS did not differ. Initial pediatric National Institutes of Health Stroke Scale score was higher in children with FCA-i in the PC with a median of 10.0 (interquartile range, 5.75-21.0) compared with 4.5 (interquartile range, 2.0-8.0) in those with AC-FCA-i. Different from the anterior cases, PC infarct volume did not correlate with higher discharge, maximum, or final FCASS scores (Pearson correlation coefficient [r], 0.25, 0.35, and 0.54).
CONCLUSIONS UNASSIGNED
FCA-i also affects the PC. These cases should be included in future investigations into FCA-i. Although it did not correlate with clinical outcomes in our cohort, the modified FCASS may well serve as a marker for the evolution of the arteriopathy in posterior FCA-i.

Identifiants

DOI: 10.1161/STROKEAHA.123.043562 PMID: 38445467
pubmed: 38445467
doi: 10.1161/STROKEAHA.123.043562
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Auteurs

Nedelina Slavova (N)

Support Center for Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital Bern University Hospital, University of Bern, Switzerland. (N.S.).
Pediatric Radiology, University of Basel Children's Hospital and University of Basel, Switzerland (N.S.).
Department of Neurology, University Hospital Bern (N.S.).
ORCID: 0000-0002-6017-7858

Robin Muenger (R)

Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern University Hospital, University of Bern, Switzerland. (R.M., I.S.-A., M.R., G.O., S.G., M.S.).
ORCID: 0000-0003-1424-4682

Iciar Sanchez-Albisua (I)

Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern University Hospital, University of Bern, Switzerland. (R.M., I.S.-A., M.R., G.O., S.G., M.S.).

Maria Regényi (M)

Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern University Hospital, University of Bern, Switzerland. (R.M., I.S.-A., M.R., G.O., S.G., M.S.).

Gabriela Oesch (G)

Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern University Hospital, University of Bern, Switzerland. (R.M., I.S.-A., M.R., G.O., S.G., M.S.).

Joël Fluss (J)

Department of Pediatrics, Gynecology and Obstetrics, Pediatric Neurology Unit, University Hospitals of Geneva, Switzerland (J.F.).
ORCID: 0000-0002-6413-162X

Annette Hackenberg (A)

Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland (A.H.).

Sébastien Lebon (S)

Pediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Switzerland (S.L.).
ORCID: 0000-0002-1666-1124

Oliver Maier (O)

Division of Child Neurology, Department of Pediatrics, Children's Hospital, St. Gallen, Switzerland (O.M.).

Alexandre N Datta (AN)

Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Switzerland (A.D.).

Sandra Bigi (S)

Institute of Social and Preventive Medicine, University of Bern, Switzerland. (S.B.).
Division of Pediatric Neurology, Department of Pediatrics, Children's Hospital Lucerne, Switzerland (S.B.).
ORCID: 0000-0003-2158-2241

Sebastian Grunt (S)

Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern University Hospital, University of Bern, Switzerland. (R.M., I.S.-A., M.R., G.O., S.G., M.S.).

Maja Steinlin (M)

Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern University Hospital, University of Bern, Switzerland. (R.M., I.S.-A., M.R., G.O., S.G., M.S.).
ORCID: 0000-0002-5194-3143

Classifications MeSH