# Acute arterial ischemic stroke in children: single-center experience

## TL;DR

This study examines acute arterial ischemic stroke cases in children, highlighting the importance of early diagnosis and treatment.

## Contribution

The study provides insights into clinical presentations and risk factors of AIS in children through a single-center retrospective analysis.

## Key findings

- Neurological deficit was the most common complaint among children with AIS.
- MTHFR gene mutations were frequently observed in AIS patients.
- Cranial CT scanning is emphasized as a critical diagnostic tool when MRI is not feasible.

## Abstract

Arterial ischemic stroke (AIS) is an increasingly common disorder in childhood that causes severe mortality and morbidity.

To emphasize the importance of early diagnosis and treatment of AIS cases, as well as the early initiation of physical therapy.

We retrospectively reviewed the medical records of 23 patients aged 1 month to 18 years, who were admitted with acute neurological complaints and diagnosed radiologically with AIS at the Bursa Yüksek İhtisas Training and Research Hospital, a tertiary healthcare facility, between January 2016 and June 2020.

Neurological deficit was the most common (12 patients; 52%) complaint, followed by seizure in 5 patients (21%), facial paralysis in 5 patients (21%), and visual impairment in 3 patients (13%). We performed brain computed tomography (CT) scans in 12 (52%) patients at the first application, and infarction was detected in 8 (66%). Infarction was in the cerebrum in 19 (82%) patients. Mutations of the
methylenetetrahydrofolate reductase
(
MTHFR
; A1298C and 677C > T) gene were found most frequently. Cardiac anomalies were detected in 7 (30%) patients, and 2 patients had ventriculoperitoneal shunts.

Arterial ischemic stroke presents very different clinical findings, such as hiccups, anisocoria, and upward gaze paralysis. We wanted to emphasize the importance of cranial CT scanning because sometimes MRI is not always easily performed in children. Concomitant conditions, such as intracranial operation, ventriculoperitoneal shunt, and hypochondroplasia, may increase the risk of stroke.