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Inflammatory Type Focal Cerebral Arteriopathy of the Posterior Circulation in Children: A Comparative Cohort Study

Title: Inflammatory Type Focal Cerebral Arteriopathy of the Posterior Circulation in Children: A Comparative Cohort Study
Authors: Slavova, Nedelina; Muenger, Robin; Sanchez-Albisua, Iciar; Regényi, Maria; Oesch, Gabriela; Fluss, Joël; Hackenberg, Annette; Lebon, Sébastien; Maier, Oliver; Datta, Alexandre N; Bigi, Sandra; Grunt, Sebastian; Steinlin, Maja
Source: Slavova, Nedelina; Muenger, Robin; Sanchez-Albisua, Iciar; Regényi, Maria; Oesch, Gabriela; Fluss, Joël; Hackenberg, Annette; Lebon, Sébastien; Maier, Oliver; Datta, Alexandre N; Bigi, Sandra; Grunt, Sebastian; Steinlin, Maja (2024). Inflammatory Type Focal Cerebral Arteriopathy of the Posterior Circulation in Children: A Comparative Cohort Study. Stroke, 55(4):1006-1014.
Publisher Information: American Heart Association
Publication Year: 2024
Collection: University of Zurich (UZH): ZORA (Zurich Open Repository and Archive
Subject Terms: Medical Clinic; 610 Medicine & health
Description: BACKGROUND Inflammatory type focal cerebral arteriopathy (FCA-i) in the anterior circulation (AC) is well characterized, and the focal cerebral arteriopathy severity score (FCASS) reflects the severity of the disease. We identified cases of FCA-i in the posterior circulation (PC) and adapted the FCASS to describe these cases. METHODS In this comparative cohort study, patients from the Swiss NeuroPaediatric Stroke Registry with ischemic stroke due to FCA-i between January 2000 and December 2018 were analyzed. A comparison between PC and AC cases regarding pediatric National Institutes of Health Stroke Scale score and pediatric stroke outcome measure and FCASS was performed. We estimated infarct size by the modified pediatric Alberta Stroke Program Early Computed Tomography Score in children with AC stroke and the adapted Bernese posterior diffusion-weighted imaging score in the PC. RESULTS Thirty-five children with a median age of 6.3 (interquartile range, 2.7-8.2 [95% CI, 0.9-15.6]; 20 male; 57.1%) years with FCA-i were identified. The total incidence rate was 0.15/100 000/year (95% CI, 0.11-0.21). Six had PC-FCA-i. Time to final FCASS was longer in the PC compared with AC; the evolution of FCASS did not differ. Initial pediatric National Institutes of Health Stroke Scale score was higher in children with FCA-i in the PC with a median of 10.0 (interquartile range, 5.75-21.0) compared with 4.5 (interquartile range, 2.0-8.0) in those with AC-FCA-i. Different from the anterior cases, PC infarct volume did not correlate with higher discharge, maximum, or final FCASS scores (Pearson correlation coefficient [r], 0.25, 0.35, and 0.54). CONCLUSIONS FCA-i also affects the PC. These cases should be included in future investigations into FCA-i. Although it did not correlate with clinical outcomes in our cohort, the modified FCASS may well serve as a marker for the evolution of the arteriopathy in posterior FCA-i.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 0039-2499
Relation: https://www.zora.uzh.ch/id/eprint/274770/1/ZORA274770.pdf; info:pmid/38445467; urn:issn:0039-2499
DOI: 10.1161/STROKEAHA.123.043562
Availability: https://www.zora.uzh.ch/id/eprint/274770/; https://www.zora.uzh.ch/id/eprint/274770/1/ZORA274770.pdf; https://doi.org/10.1161/STROKEAHA.123.043562
Rights: info:eu-repo/semantics/openAccess ; Creative Commons: Attribution 4.0 International (CC BY 4.0) ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.B010DBF
Database: BASE