AUTHOR=Luckman Judith , Chokron Sylvie , Michowiz Shalom , Belenky Eugenia , Toledano Helen , Zahavi Alon , Goldenberg-Cohen Nitza 

TITLE=The Need to Look for Visual Deficit After Stroke in Children

JOURNAL=Frontiers in Neurology

VOLUME=Volume 11 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00617

DOI=10.3389/fneur.2020.00617

ISSN=1664-2295

ABSTRACT=Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up.
Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical center in 2005-2016. Demographic data and findings on radiological neuroimaging and ophthalmological and neurological examination were retrieved from the medical files.
Results: The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (n=5, 19.2%), cardiac anomaly or Fontan repair (n=3 each, 11.5%), vascular anomaly (n=3, 11.5%), head trauma with traumatic dissection (n=3, 11.5%), and  hypercoagulability (n=1, 3.8%); in 8 patients (30.8%), no apparent cause was found. Eleven patients (42.3%) had a non-ophthalmological neurological deficit as a result of the stroke. Eye examination was performed in 9 patients (34.6%) during follow-up. Ophthalmological manifestations included hemianopic visual field defect in 7 patients (7.7%) and complete blindness and poor visual acuity in one patient each (3.8%). At the last visit, no change in visual function was detected. 
Conclusion:   The variable etiology and presentation of pediatric stroke may mask specific visual signs. Children with arterial stroke should be referred for early ophthalmological evaluation and visual rehabilitation.