This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rafay, M. F. Articles by MacGregor, D. L. Search for Related Content PubMed PubMed Citation Articles by Rafay, M. F. Articles by MacGregor, D. L. Pubmed/NCBI databases Medline Plus Health Information Stroke Social Bookmarking                         What's this?

Craniocervical Arterial Dissection in Children: Clinical and Radiographic Presentation and Outcome

Division of Neurology

Derek Armstrong, MD

Division of Neurology, Department of Pediatrics, Division of Neuroradiology

Gabrielle deVeber, MD, MSc

Division of Neurology, Department of Diagnostic Imaging, and Population Health Sciences Program

Trish Domi, MSc

Division of Neurology

Anthony Chan, MD

The Hospital for Sick Children, Toronto, ON, Canada

Daune L. MacGregor, MD

Division of Neurology daune. macgregor{at}sickkids.ca.

Craniocervical arterial dissection is a recognized cause of arterial ischemic stroke in children. Whether children with craniocervical arterial dissection have dissection characteristics different from those of adults is unclear. A retrospective review of children, 1 month to 18 years of age, with dissection from two Canadian pediatric ischemic stroke registry centers was conducted. From 213 patients with arterial ischemic stroke, 16 (7.5%) were identified with dissection, 37.5% had warning symptoms, and 50% had a history of head or neck trauma. The clinical presentation included headache (44%), altered consciousness (25%), seizures (12.5%), and focal deficits (87.5%). Dissection involved extracranial vessels in 75% and anterior circulation in 56%. Follow-up included complete recovery in 43%, mild to moderate deficits in 44%, and severe deficits in 13%. Fourteen (87.5%) children received antithrombotic treatment. Follow-up angiography showed resolution of abnormalities in 60% of vessels. Total occlusion had the worst outcome for recanalization. In conclusion, the etiology of arterial dissection in the majority of children appears to be either trauma or idiopathic. Long-term angiography shows variable outcomes, depending on the initial findings. The relationship of angiographic outcomes with recurrent strokes requires further study in pediatric dissection. ( J Child Neurol 2006;21:8—16).

Journal of Child Neurology, Vol. 21, No. 1, 8-16 (2006)
DOI: 10.1177/08830738060210010101


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. A. Tan, G. deVeber, A. Kirton, L. Vidarsson, D. MacGregor, and M. Shroff Low Detection Rate of Craniocervical Arterial Dissection in Children Using Time-of-Flight Magnetic Resonance Angiography: Causes and Strategies to Improve Diagnosis J Child Neurol, October 1, 2009; 24(10): 1250 - 1257. [Abstract] [PDF]

				P. Frosk, M. S. Salman, J. Wrogemann, N. Shah, and M. F. Rafay Recurrent Posterior Circulation Stroke in an Infant With Basilar Artery Aneurysm J Child Neurol, August 1, 2009; 24(8): 1019 - 1020. [Abstract] [PDF]

				M. A. Tan, D. Armstrong, D. L. MacGregor, and A. Kirton Late Complications of Vertebral Artery Dissection in Children: Pseudoaneurysm, Thrombosis, and Recurrent Stroke J Child Neurol, March 1, 2009; 24(3): 354 - 360. [Abstract] [PDF]

				K. P. J. Braun, M. M. M. Bulder, S. Chabrier, F. J. Kirkham, C. S. P. Uiterwaal, M. Tardieu, and G. Sebire The course and outcome of unilateral intracranial arteriopathy in 79 children with ischaemic stroke Brain, February 1, 2009; 132(2): 544 - 557. [Abstract] [Full Text] [PDF]

				J Pappachan and F J Kirkham Cerebrovascular disease and stroke Arch. Dis. Child., October 1, 2008; 93(10): 890 - 898. [Abstract] [Full Text] [PDF]

				E. S. Roach, M. R. Golomb, R. Adams, J. Biller, S. Daniels, G. deVeber, D. Ferriero, B. V. Jones, F. J. Kirkham, R. M. Scott, et al. Management of Stroke in Infants and Children: A Scientific Statement From a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young Stroke, September 1, 2008; 39(9): 2644 - 2691. [Abstract] [Full Text] [PDF]

				P. Monagle, E. Chalmers, A. Chan, G. deVeber, F. Kirkham, P. Massicotte, and A. D. Michelson Antithrombotic Therapy in Neonates and Children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 887S - 968S. [Abstract] [Full Text] [PDF]

				J. Ui and L. Sivaswamy Hemiplegia in an 11-Year-Old Clinical Pediatrics, March 1, 2008; 47(2): 199 - 202. [PDF]

				T. J. Bernard, G. A. deVeber, and T. A. Benke Athletic Participation After Acute Ischemic Childhood Stroke: A Survey of Pediatric Stroke Experts J Child Neurol, August 1, 2007; 22(8): 1050 - 1053. [Abstract] [PDF]

				G. A. Ortiz, S. Koch, D. M. Wallace, and R. Lopez-Alberola Successful Intravenous Thrombolysis for Acute Stroke in a Child J Child Neurol, June 1, 2007; 22(6): 749 - 752. [Abstract] [PDF]

				K. P.J. Braun, M. F. Rafay, C. S.P. M. Uiterwaal, A.-M. Pontigon, and G. DeVeber Mode of Onset Predicts Etiological Diagnosis of Arterial Ischemic Stroke in Children Stroke, February 1, 2007; 38(2): 298 - 302. [Abstract] [Full Text] [PDF]