Trauma, infection link with stroke seen in children

By Helen Albert, Senior medwireNews Reporter

Research shows that trauma and acute infection are significant risk factors for arterial ischemic stroke (AIS) in children.

Previous studies have demonstrated that experiencing head or neck trauma or minor acute infections such as influenza can increase risk for stroke among adults; the current findings suggest these factors are also influential at a young age.

Heather Fullerton (University of California, San Francisco, USA) and colleagues carried out a case-control study of 126 children who were admitted to hospital with AIS and 378 age- and primary care facility-matched controls. All the children were selected from a cohort of 2.5 million children and adolescents aged 19 years or younger who were enrolled in the Kaiser Permanente Medical Care Program.

As reported in the Annals of Neurology, the team found that children who had medical treatment for head or neck trauma within the previous 12 weeks had a 7.5-fold increased risk for AIS compared with those who had not.

The median time to stroke following head or neck trauma was short, at a median of 0.5 days, and when trauma exposure was redefined as being within the past week, the increased risk for AIS was much greater, at 39 times the risk among children who had not experienced trauma during this period.

Similarly, seeking treatment for a minor infection such as upper respiratory tract infection, acute otitis media, or acute gastroenteritis within the previous 4 weeks also increased the risk for AIS 4.6-fold compared with having no infection over this time. Overall, 33% of children who had AIS had a history of infection over the previous month compared with 13% of controls.

The team notes that similar to previous findings in adults, no specific infection seemed to increase AIS risk in children more than the others.

"Whereas adult AIS is largely attributable to atherosclerotic risk factors, childhood AIS has been linked to a variety of chronic conditions: congenital heart disease, hematological disorders, and autoimmune diseases," write the authors.

"However, the majority of children are healthy at the time of their first AIS, suggesting other potential risk factors."

The findings of this study suggest that trauma and acute infection could be used as "targets for stroke prevention strategies," in this age group, conclude Fullerton and co-workers.

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