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Research ArticlePediatrics
Open Access

Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study

M. Wintermark, N.K. Hills, G.A. DeVeber, A.J. Barkovich, T.J. Bernard, N.R. Friedman, M.T. Mackay, A. Kirton, G. Zhu, C. Leiva-Salinas, Q. Hou, H.J. Fullerton and the VIPS Investigators
American Journal of Neuroradiology November 2017, 38 (11) 2172-2179; DOI: https://doi.org/10.3174/ajnr.A5376
M. Wintermark
aFrom the Department of Radiology (M.W.), Neuroradiology Division, Stanford University, Stanford, California
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N.K. Hills
bDepartments of Neurology (N.K.H., H.J.F.)
cBiostatistics and Epidemiology (N.K.H.)
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G.A. DeVeber
fDepartment of Neurology (G.A.D.), Hospital for Sick Children, Toronto, Ontario, Canada
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A.J. Barkovich
dRadiology (A.J.B., H.J.F.)
ePediatrics (A.J.B.),University of California, San Francisco, San Francisco, California
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T.J. Bernard
gDepartment of Pediatrics (T.J.B.), University of Colorado, Denver, Colorado
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N.R. Friedman
hCenter for Pediatric Neurology (N.R.F.), Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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M.T. Mackay
iChildren's Stroke Program (M.T.M.), Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
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A. Kirton
jDepartments of Pediatrics and Clinical Neurosciences (A.K.), Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada
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G. Zhu
kDepartment of Neurology (G.Z.), Military General Hospital of Beijing PLA, Beijing, China
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C. Leiva-Salinas
lDepartment of Radiology (C.L.-S.), University of Virginia, Charlottesville, Virginia
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Q. Hou
mDepartment of Neurology (Q.H.), Guangdong No.2 Provincial People's Hospital, Guangzhou, China.
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H.J. Fullerton
bDepartments of Neurology (N.K.H., H.J.F.)
dRadiology (A.J.B., H.J.F.)
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Figures

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  • Fig 1.
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    Fig 1.

    Classification of stroke subtype among 355 children with arterial ischemic stroke enrolled in the VIPS study. The cases used for the current study are highlighted in gray.

  • Fig 2.
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    Fig 2.

    Banding pattern observed in 24% of patients with FCA-i.

Tables

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  • Summary results of independent predictors of arteriopathy subtypes

    Arteriopathy SubtypeCardioembolicDissectionFCA-iMoyamoyaSecondary VasculitisOther Definite
    Demographic characteristics
        Black race vs other+++
    Clinical characteristics
        Congenital or acquired heart disease+++
        Down syndrome+++
        Meningitis+++
        Sepsis/bacteremia+++
        Head trauma+++
    Presentation
        Dysarthria++
        Nausea/vomiting+
        Vertigo+++
        Decreased level of consciousness−+++
    Infarct characteristics: location
        Lenticulostriate artery territory+++
    Infarct characteristics: volume
        Infarct volume (smaller)++
    Vascular imaging abnormal findings
        Occlusion−
        Stenosis−
        Irregularity−
        Banding+++
        >1 vascular territory−+++
        >1 arterial segment−
    Affected artery
        Proximal MCA (M1)+++
        Distal ICA (supraclinoid)++++++
        Cervical artery+++
    • Note:—Positive association: +++ indicates odds ratio > 20; ++, OR 5–15; +, 1 < OR < 5; P < .05 in all. Negative association: −, OR < 1 and P < .05.

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American Journal of Neuroradiology: 38 (11)
American Journal of Neuroradiology
Vol. 38, Issue 11
1 Nov 2017
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Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study
M. Wintermark, N.K. Hills, G.A. DeVeber, A.J. Barkovich, T.J. Bernard, N.R. Friedman, M.T. Mackay, A. Kirton, G. Zhu, C. Leiva-Salinas, Q. Hou, H.J. Fullerton, the VIPS Investigators
American Journal of Neuroradiology Nov 2017, 38 (11) 2172-2179; DOI: 10.3174/ajnr.A5376

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Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study
M. Wintermark, N.K. Hills, G.A. DeVeber, A.J. Barkovich, T.J. Bernard, N.R. Friedman, M.T. Mackay, A. Kirton, G. Zhu, C. Leiva-Salinas, Q. Hou, H.J. Fullerton, the VIPS Investigators
American Journal of Neuroradiology Nov 2017, 38 (11) 2172-2179; DOI: 10.3174/ajnr.A5376
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