Arterial ischemic stroke and hemorrhagic stroke in Chinese children: A retrospective analysis

  • Ling-ling Xie
    Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, PR China
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  • Li Jiang
    Corresponding author. Address: Department of Neurology, Children’s Hospital of Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, PR China. Tel.: +86 23 63624424; fax: +86 23 63622874.
    Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, PR China
    Search for articles by this author


      To study the characteristics of pediatric arterial ischemic stroke (AIS) and hemorrhagic stroke (HS) in southwest of China, and analyze the etiology and risk factor. This study retrospectively reviewed the records of all patients in both department of neurology and department of neurosurgery in Children’s hospital of Chongqing medical university from January 2003 to March 2011, and patients were eligible for analysis if they had been diagnosed with AIS or HS. And SPSS 17.0 software was used for statistical analysis. The χ2 test was used to exam relationships between stroke types and sex, age, and that between neuroradiological images and sex. 119 Boys (70.4%) and 50 girls (29.6%) were included. In these cases, HS accounted for the majority of the cases (n = 109, 64.1%), and vitamin K deficiency was a major etiology in 65 out of 109 HS (59.6%), most of which occurred in breastfeeding infants (87.7%) and those who received no vitamin K after birth. AIS accounted for 35.3% of the cases, and minor head injury associated stroke (40.0%) was more common than vasculopathy associated stroke (16.6%) and other kinds of stroke. HS in children is more common than AIS. Vitamin K deficiency was a major etiology in these young infants who experienced HS, and many cases of AIS were associated with minor head injury.


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        • Earley C.J.
        • Kittner S.J.
        • Feeser B.R.
        • Gardner J.
        • Epstein A.
        • Wozniak M.A.
        • et al.
        Stroke in children and sickle-cell disease: Baltimore Washington Cooperative Young Stroke Study.
        Neurology. 1998; 51: 169-176
        • Giroud M.
        • Lemesle M.
        • Gouyon J.B.
        • Nivelon J.L.
        • Milan C.
        • Dumas R.
        Cerebrovascular disease in children under 16 years of age in the city of Dijon, France: a study of incidence and clinical features from 1985 to 1993.
        J. Clin. Epidemiol. 1995; 48: 1343-1348
        • Lynch J.
        • Hirtz D.
        • deVeber G.
        • Nelson K.B.
        Report of the national institute of neurological disorders and stroke workshop on perinatal and childhood stroke.
        Pediatrics. 2002; 109: 116-123
        • Fullerton H.J.
        • Wu Y.W.
        • Zhao S.
        • Johnston S.C.
        Risk of stroke in children: ethnic and gender disparities.
        Neurology. 2003; 61: 189-194
        • Hartel C.
        • Schilling S.
        • Sperner J.
        • Thyen U.
        The clinical outcomes of neonatal and childhood stroke: review of the literature and implications for future research.
        Eur. J. Neurol. 2004; 11: 431-438
        • Lynch J.K.
        Cerebrovascular disorders in children.
        Curr. Neurol. Neurosci. Rep. 2004; 4: 129-138
        • Palm F.
        • Urbanek C.
        • Wolf J.
        • Buggle F.
        • Kleemann T.
        • Hennerici M.G.
        • et al.
        Etiology, risk factors and sex differences in ischemic stroke in the ludwigshafen stroke study, a population-based stroke registry.
        Cerebrovasc. Dis. 2012; 33: 69-75
        • Grysiewicz Rebbeca A.
        • Thomas Kurian
        • Pandey Dilip K.
        Epidemiology of ischemic and hemorrhagic stroke: incidence, prevalence, mortality, and risk factors.
        Neurol. Clin. 2008; 26: 871-895
        • Steve Roach E.
        • Golomb Meredith R.
        • Adams Robert
        • Biller J.
        • Daniels S.
        • Deveber G.
        • 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. 2008; 39: 2644-2691
        • Wang J.-J.
        • Shi K.-L.
        • Li J.-W.
        • Jiang L.Q.
        • Caspi O.
        • Fang F.
        • et al.
        Risk factors for arterial ischemic and hemorrhagic stroke in childhood.
        Pediatr. Neurol. 2009; 40: 277-281
        • Chung Brian
        • Wong Virginia
        Pediatric stroke among Hong Kong Chinese subjects.
        Pediatrics. 2004; 114: e206-e212
        • Grau Armin J.
        • Urbanek Christian
        • Palm Frederick
        Common infections and the risk of stroke.
        Nat. Rev. Neurol. 2010; 6: 681-694
        • Askalan Rand
        • Laughlin Suzanne
        • Mayank Supriya
        • Chan A.
        • MacGregor D.
        • Andrew M.
        • et al.
        Chicken pox and stroke in childhood, a study of frequency and causation.
        Stroke. 2001; 32: 1257-1262
        • Golomb Meredith R.
        • Fullerton Heather J.
        • Nowak-Gottl Ulrike
        • Deveber G.
        International Pediatric Stroke Study Group. Male predominance in childhood ischemic stroke: findings from the International Pediatric Stroke Study.
        Stroke. 2009; 40: 52-57
        • Balci K.
        • Utku U.
        • Asil T.
        • Celik Y.
        Ischemic stroke in young adults: risk factors, subtypes, and prognosis.
        Neurologist. 2011; 17: 16-20
        • Czlonkowska A.
        • Ciesielska A.
        • Gromadzka G.
        • Kurkowska-Jastrzebska I.
        Gender differences in neurological disease: role of estrogens and cytokines.
        Endocrine. 2006; 29: 243-256
        • Munot P.
        • De Vile C.
        • Hemingway C.
        • Gunny R.
        • Ganesan V.
        Severe iron deficiency anaemia and ischaemic stroke in children.
        Arch. Dis. Child. 2011; 96: 276-279
        • Ogata K.
        • Yagawa K.
        • Hayashi S.
        • Ogino H.
        • Miyagawa Y.
        • Miyazaki M.
        • et al.
        Thrombosis-inducing activity in plasma of patients with acute respiratory tract infection disappears after treatment.
        Respiration. 1991; 58: 176-180
        • van der Poll Tom
        • Büller Harry R.
        • ten Cate Hugo
        • Wortel C.H.
        • Bauer K.A.
        • van Deventer S.J.
        • et al.
        Activation of coagulation after administration of tumor necrosis factor to normal subjects.
        N. Engl. J. Med. 1990; 322: 1622-1627
        • Macko Richard F.
        • Ameriso Sebastain F.
        • Gruber Andras
        • Griffin J.H.
        • Fernandez J.A.
        • Barndt R.
        • et al.
        Impairments of the protein C system and fibrinolysis in infection-associated stroke.
        Stroke. 1996; 27: 2005-2011
        • Epstein Stephen E.
        • Zhu Jianhui
        • Najafi Amir H.
        • Burnett M.S.
        Insights into the role of infection in atherogenesis and in plaque rupture.
        Circulation. 2009; 119: 3133-3141
        • Lo Warren D.
        • Lee JoEllen
        • Rusin Jerome
        • Perkins E.
        • Roach E.S.
        Intracranial hemorrhage in children, an evolving spectrum.
        Arch. Neurol. 2008; 65: 1629-1633