Ischaemic stroke in children with cardiopathy: An epidemiological study

Abstract

Introduction: Ischaemic stroke is rare during childhood. Congenital and acquired heart diseases are one of the most important risk factors for arterial ischaemic stroke (AIS) in children.

Patients and methods: We conducted a retrospective study of all children with AIS and heart disease diagnosed between 2000 and 2014.

Results: We included 74 children with heart disease who were eligible for inclusion. 60% were boys with a mean stroke age of 11 months. 20% of the patients died during the study period. 90% of the patients had a congenital heart disease, while cyanotic heart disease was identified in 60%. Hypoplastic left heart syndrome was the most frequent heart disease. In 70% of patients AIS was directly associated with heart surgery, catheterisation or ventricular assist devices. Most patients with AIS were in the hospital. Seizures and motor deficit were the most frequent symptoms. Most patient diagnoses were confirmed by brain CT. The AIS consisted of multiple infarcts in 33% of the cases, affected both hemispheres in 27%, and involved the anterior and posterior cerebral circulation in 10%.

Conclusions: Arterial ischaemic strokes were mainly associated with complex congenital heart diseases, and heart procedures and surgery (catheterisation). AIS presented when patients were in-hospital and most of the patients were diagnosed in the first 24hours.

Keywords: Arterial ischaemic disease; Cardiopatía congénita; Cateterismo; Catheterisation; Cirugía cardiaca; Congenital heart disease; Enfermedad cardiaca; Heart disease; Heart surgery; Hypoplastic left heart syndrome; Ictus isquémico; Ventrículo izquierdo hipoplásico.