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        <title>Frontiers in Stroke | Stroke in the Young section | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/stroke/sections/stroke-in-the-young</link>
        <description>RSS Feed for Stroke in the Young section in the Frontiers in Stroke journal | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-02T20:28:01.798+00:00</pubDate>
        <ttl>60</ttl>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2025.1676220</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2025.1676220</link>
        <title><![CDATA[Association between RoPE score and PFO grading on bubble echocardiography in cryptogenic stroke patients: a retrospective cohort study]]></title>
        <pubdate>2026-01-09T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Saeedur Rahman</author><author>Erik Hendrickson</author><author>Jamie Henderson</author><author>Samuel McGrath</author><author>Ayah Mekhaimar</author><author>Kishen Mathi</author><author>Jake Hudson</author><author>Robert Sargent</author><author>Brian Clapp</author>
        <description><![CDATA[IntroductionIdentification of high-risk anatomical and physiological features of a patent foramen ovale (PFO) is important for patient selection for transcatheter device closure of PFO in patients with cryptogenic stroke. Currently, there are no clinical screening tools in use that can be used in predicting high-risk PFO features before undertaking transoesophageal echocardiography.MethodsThis retrospective cohort study, conducted in a stroke unit in South East England, included 130 patients diagnosed with ischaemic stroke or transient ischaemic attack who were deemed as cryptogenic in nature following initial evaluation (≤55 years with no known risk factors or immediately identified underlying etiology). Patients underwent comprehensive diagnostic evaluations, including bubble echocardiography. The primary predictor, risk of paradoxical embolism (RoPE) score (≥6), was assessed for its association with a significant PFO, categorized as model 1 (≥small) and model 2 (≥moderate). Multivariable logistic regression models were used to estimate adjusted odds ratios for the relationship between RoPE score and PFO presence.ResultsOf the 130 patients, 47 had a known etiology, and 83 had cryptogenic stroke. The known etiology group had higher rates of hypertension, hyperlipidaemia, and non-stenotic atherosclerosis, while the cryptogenic group had more cortical strokes and higher RoPE scores. Multivariable analysis showed that a lower RoPE score (≤5) was associated with known etiology (aOR: 3.91, p < 0.01). RoPE scores ≥6 were significantly associated with both small and moderate PFOs (aORs: 5.39, p < 0.01 and 15.95, p < 0.01, respectively). Of 28 candidates for PFO closure, 20 underwent the procedure, all with high RoPE scores and large PFOs.DiscussionThis study reinforces the importance of a multidisciplinary approach in the evaluation and management of patients with PFO and suspected embolic stroke. While PFO is prevalent in both cryptogenic and non-cryptogenic stroke patients, its pathogenic role is highly context dependent. Our findings confirm that a high RoPE score (≥6) and a cortical stroke phenotype are independently associated with clinically relevant, higher-grade PFOs. Furthermore, patients selected for device closure consistently exhibited high RoPE scores and multiple high-risk anatomical features, aligning with current international guidelines. Importantly, low RoPE scores (≤5) were significantly associated with strokes of known etiology, underscoring the utility of the RoPE score not only in identifying likely PFO-related strokes but also in ruling out embolic mechanisms. These results support the integration of clinical scoring systems like RoPE for patient selection about the suitability for device closures as higher RoPE scores predict high-risk PFO and therefore minimize unnecessary interventions.ConclusionRoPE scores may be utilized in predicting high-risk anatomical and physiological features of PFO. However, larger prospective studies are needed to validate these findings and refine pre-transoesophageal echocardiography screening tools.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2025.1718355</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2025.1718355</link>
        <title><![CDATA[Striving toward quality metrics for pediatric stroke: time from door to diagnosis]]></title>
        <pubdate>2026-01-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Rachel Pearson</author><author>Nancy K. Hills</author><author>Kellie Bacon</author><author>Shelby K. Shelton</author><author>Rowena Roque</author><author>Tatiana Moreno</author><author>Maria Kuchherzki</author><author>Carl Schultz</author><author>Theodore W. Heyming</author><author>Christine K. Fox</author><author>Heather J. Fullerton</author>
        <description><![CDATA[Background/ObjectiveMost pediatric stroke survivors suffer long-term impairments. To minimize injury, it is essential to quickly restore perfusion to viable brain tissue. Minimizing the time to stroke diagnosis requires recognition of a possible stroke by prehospital and emergency healthcare personnel, and rapid neuroimaging. While CT suffices for diagnosing hemorrhagic stroke, MRI is necessary to diagnose acute ischemic stroke (IS), contributing to significant diagnostic delays and potentially missed opportunities for intervention.MethodsWe conducted a retrospective study of children 1–14 years old with acute neurological symptoms presenting by Emergency Medical Services (EMS) to the study institution from 1/2019–6/2023. We described patient characteristics and neuroimaging studies, then evaluated predictors of MRI acquisition and actionable findings, including stroke. To assess the generalizability of these data we analyzed a secondary retrospective cohort of all children admitted during this period with out-of-hospital strokes regardless of presentation modality [EMS, emergency department (ED) walk-in, and transfer].ResultsAmong 3,888 pediatric patients with acute neurological symptoms presenting via EMS, 695 (17.9%) had neuroimaging: CT only in 570 patients (14.7%); CT and MRI in 125 (3.2%). Median (IQR) times from EMS activation to neuroimaging were 2.29 (1.56, 3.21) hours for CT and 26.8 (16.3, 43.8) hours for MRI. An EMS primary impression of “stroke” was rare (n = 13) but strongly predictive of imaging acquisition: all had CT and 11 had MRI. Thirty-one of the 125 patients with MRI had actionable MRIs, including nine acute strokes. During the study period another 14 stroke patients presented as ED walk-ins. Median time from ED arrival to CT was 0.92 (0.47, 1.08) hours for EMS patients with hemorrhagic stroke and 5.69 (1.50, 9.76) hours for walk-ins; for MRI, median time was 4.15 (3.00, 5.31) hours for EMS patients with ischemic stroke and 10.2 (1.99, 36.3) hours for walk-ins.ConclusionAmong children with acute neurological symptoms selected for neuroimaging, CT was the most common modality while MRIs were performed with a substantial time delay. While EMS providers rarely suspected stroke, their diagnosis impacted imaging decisions in the ED, suggesting a need to raise awareness among prehospital providers. To measure quality improvement in pediatric stroke, new pediatric-specific metrics like “door to diagnosis” time, should be further explored.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2025.1692460</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2025.1692460</link>
        <title><![CDATA[Challenges in acute management of cerebral sinovenous thrombosis among neonates with acute kidney injury: a retrospective cohort study]]></title>
        <pubdate>2025-12-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Manish Parakh</author><author>Marilyn Tan</author><author>Ankit Kumar Meena</author>
        <description><![CDATA[IntroductionCerebral sinovenous thrombosis (CSVT) in neonates with acute kidney injury (AKI) is a rare neurologic condition with potential serious consequences. Rapid diagnosis is key to good outcomes. This study aims to identify challenges in acute care and to evaluate outcomes of these patients in a resource-limited setting.Materials and methodsThis retrospective cohort study included term neonates with AKI and CSVT admitted at a tertiary center in Western India (January 2021–January 2023). Clinical profile, timing of consult with healthcare providers, diagnosis, neuroimaging, management strategies, and outcomes at discharge and at age 2 years were analyzed.ResultsA total of 31 neonates (19 male) with mean age 18.5 ± 6.6 days at diagnosis were included. Dehydration was the most common risk factor in 80.6%, while seizures were the most common clinical presentation (80.6% patients). Almost 84% of patients had thrombosis in multiple sinuses. Venous infarcts were identified in 20 (64.5%) patients, with concomitant hemorrhage in 13 (42%). Only 10 patients received anticoagulation therapy. Median time from symptom onset to consult in first healthcare facility was 48 h [interquartile range (IQR): 44–72 h]. Eighteen patients (58.06%) were subsequently referred to a second facility after a median stay of 48 h (IQR: 28–72 h). At the secondary or tertiary referral center, diagnostic neuroimaging was performed after a median of 48 h (IQR: 36–108 h). Anticoagulation was initiated within a median of 2 h (IQR: 2–2.75 h) following the diagnosis of CSVT. Although all patients survived, 32% had neurologic sequelae at discharge which persisted at the 2-year follow-up. Complete vessel recanalization on follow-up neuroimaging was achieved in all anticoagulated patients, compared with 66.7% of those who were not anticoagulated. However, statistical analysis showed no significant association between anticoagulation therapy and either clinical outcome or vessel recanalization.ConclusionNeonatal CSVT associated with AKI can lead to persistent neurologic deficits at 2 years. Timely diagnosis and management remain a significant challenge in resource-limited settings due to delays both before and during hospitalization. Although anticoagulation treatment was not associated with outcomes in our cohort, further research is needed to develop acute care guidelines, applicable across diverse clinical settings, particularly in resource-limited situations.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2025.1503574</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2025.1503574</link>
        <title><![CDATA[Burden of stroke in adolescents and young adults (aged 15–39 years) in South East Asia: a trend analysis from 1990 to 2021 based on the global burden of disease study 2021]]></title>
        <pubdate>2025-02-21T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Prakasini Satapathy</author><author>Shubham Chauhan</author><author>Shilpa Gaidhane</author><author>Ashok Kumar Bishoyi</author><author>G. Padma Priya</author><author>Karthikeyan Jayabalan</author><author>Swati Mishra</author><author>Shilpa Sharma</author><author>Ganesh Bushi</author><author>Muhammed Shabil</author><author>Rukshar Syed</author><author>Kamal Kundra</author><author>Navneet Dev</author><author>Sabah Ansar</author><author>Sanjit Sah</author><author>Quazi Syed Zahiruddin</author><author>Shailesh Kumar Samal</author><author>Diptismita Jena</author><author>Khang Wen Goh</author>
        <description><![CDATA[BackgroundStroke is a leading cause of morbidity and mortality globally, yet its burden among adolescents and young adults (aged 15–39 years) in South East Asia (SEA) remains understudied. Understanding regional trends and risk factors in this population is critical for effective prevention and management strategies. This study aims to examine stroke trends from 1990 to 2021, focusing on ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in SEA.MethodsUsing data from the Global Burden of Disease (GBD) 2021 study, temporal trends in stroke incidence, mortality, and Disability-Adjusted Life Years (DALYs) were analyzed for the age group 15–39 years. Join point regression analysis was employed to identify significant changes in stroke trends, and gender specific patterns were also assessed.ResultsIschemic stroke cases in SEA increased from 28030.85 to 40836.18, with a slight rise in incidence, particularly affecting males aged 30–39, while female mortality dropped by 23.81%. ICH incidence decreased annually by 0.6692%, with significant reductions in DALYs and mortality, especially among younger age groups and females. SAH incidence declined by 0.2142%, accompanied by a notable reduction in female mortality (31.83%). Countries with lower SDI experienced higher stroke incidence and mortality rates, highlighting socio-economic disparities. Geographic analysis revealed the Philippines had the highest rise in ischemic stroke, while most other countries saw declines in ICH and SAH rates.ConclusionThe study highlights significant progress in managing ICH and SAH, especially among younger populations and females. However, ischemic stroke remains a growing challenge, particularly for males, necessitating targeted interventions to reduce the overall stroke burden.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1444718</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1444718</link>
        <title><![CDATA[Identifying strokes in Nigerian children with sickle cell disease as part of clinical trials: training curriculum for healthcare professionals in low-income settings]]></title>
        <pubdate>2025-01-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Djamila L. Ghafuri</author><author>Halima Bello-Manga</author><author>Fenella J. Kirkham</author><author>Mariana Ciobanu</author><author>Edwin Trevathan</author><author>Mark Rodeghier</author><author>Michael R. DeBaun</author><author>Lori C. Jordan</author>
        <description><![CDATA[IntroductionNigeria has the highest proportion of children with sickle cell anemia (SCA) globally; without transcranial Doppler screening and ongoing treatment (regular blood transfusions or hydroxyurea therapy), 10% will have a stroke in childhood. In low-resource settings, training to recognize and prevent strokes in children with SCA is vital. A sustainable Sickle Cell Disease Stroke Prevention Teams program was established, as part of clinical trials, to address the need for stroke care in northern Nigeria. We describe our health professional stroke training curriculum and specific application to detect strokes in clinical trials in low-resource settings.MethodsChildren aged 5–12 and 2–16 years with SCA in northern Nigeria were enrolled in the SPRING and SPRINT primary and secondary stroke prevention trials, respectively. The primary outcome measure in both trials was a clinical stroke based on the World Health Organization definition. Non-neurologist physicians were trained in-person and via video lectures regarding stroke recognition, performing neurological examinations using the adapted Pediatric NIH Stroke Scale, and acute stroke care. Central stroke adjudicators, two pediatric neurologists, reviewed the case report forms and recorded videos of the neurological examinations.ResultsSix physicians completed the curriculum at three sites and were certified to detect strokes. Of 20 children with suspected stroke, 8 and 11 children had acute initial or acute recurrent strokes confirmed in the SPRING (N = 220) and SPRINT (N = 101) trials, respectively. The concordance rate between local stroke diagnoses and the central stroke adjudication process was 95% (19 of 20). One child presented with non-specific symptoms and hypertonia and was mislabeled locally as an acute stroke.DiscussionA curriculum to train healthcare providers in pediatric acute stroke recognition and care in a low-resource setting is feasible and sustainable. We successfully identified strategies for task shifting from a single pediatric neurologist in the region to multiple non-neurologist physicians.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1488313</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1488313</link>
        <title><![CDATA[Identifying predictors of stroke in young adults: a machine learning analysis of sex-specific risk factors]]></title>
        <pubdate>2024-11-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Molly Jacobs</author><author>Noah Hammarlund</author><author>Elizabeth Evans</author><author>Charles Ellis</author>
        <description><![CDATA[IntroductionStroke among Americans under age 49 is increasing. While the risk factors for stroke among older adults are well-established, evidence on stroke causes in young adults remains limited. This study used machine learning techniques to explore the predictors of stroke in young men and women.MethodsThe least absolute shrinkage and selection operator algorithm (LASSO) was applied to data from Wave V of the National Longitudinal Survey of Adolescent to Adult Health (N = 12,300)—nationally representative, longitudinal panel containing demographic, lifestyle, and clinical information for individuals aged 33–43—to identify the key factors associated with stroke in men and women. The resulting LASSO model was tested and validated on an independent sample and model performance was assessed using the area under the receiver operating characteristic curve (AUC) and calibration. For robustness, synthetic minority over sampling technique (SMOTE) was applied to address data imbalance and analyses were repeated on the balanced sample.ResultsApproximately 1.1% (N = 59) and 1.3% (N = 90) of the 5,318 and 6,970 men and women in the sample reported having a stroke. LASSO was used to predict stroke using demographic, lifestyle, and clinical predictors on both balanced and imbalanced data sets. LASSO performed slightly better on the balanced data set for women compared to the unbalanced set (Female AUC: 0.835 vs. 0.842), but performance for men was nearly identical (Male AUC: 0.820 vs. 0.822). Predictor identification was similar across both sets. For females, marijuana use, receipt of health services, education, self-rated health status, kidney disease, migraines, diabetes, depression, and PTSD were predictors. Among males, income, kidney disease, heart disease, diabetes, PTSD, and anxiety were risk factors.ConclusionsThis study showed similar clinical risk factors among men and women. However, variations in the behavioral and lifestyle determinants between sexes highlight the need for tailored interventions and public health strategies to address sex-specific stroke risk factors among young adults.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1390220</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1390220</link>
        <title><![CDATA[Prevention of stroke and cognitive decline in pediatric population in resource-limited settings]]></title>
        <pubdate>2024-11-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Ukamaka Dorothy Itanyi</author><author>Obiageli Eunice Nnodu</author>
        <description><![CDATA[There is an increasing global burden of pediatric stroke especially in low- and middle-income countries (LMICs). This is worsened by the specific risk factors in these areas, including Sickle Cell Disease and endemic infections like Tuberculosis and Human Immunodeficiency disease. Stroke occurs 221–300 times more frequently in patients with SCD when compared to healthy children. Although established stroke units and acute stroke care can improve outcomes, these are often not available in resource-poor settings. Primary and secondary prevention of strokes become a very important strategy to reduce the mortality and debilitating physical and cognitive long-term effects of stroke. There are myriads of challenges with implementing already established global policies and guidelines for stroke care in LMICs. These include paucity of data on this subject, poor knowledge and awareness about the symptoms of childhood stroke, adverse cultural beliefs regarding strokes, lack of screening and diagnostic equipment, inadequately trained manpower as well as nonexistent evidence-based management guidelines in these regions. To address these challenges, simple, cost-effective, stroke care models that determine the process of care and how available services should be delivered have been proposed to suit the peculiarities of LMICs in the areas of stroke risk assessment, prevention, and management.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1384767</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1384767</link>
        <title><![CDATA[Transcranial Doppler in 150 Congolese children with sickle cell disease]]></title>
        <pubdate>2024-09-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Gisele Tshiama Kazadi</author><author>Didier Mukendi Mbuyi</author><author>Robert Kitenge</author><author>Smith Mpaka</author><author>Jean Lambert Ehungu Gini</author><author>René Ngiyulu</author><author>Léon Muepu Tshilolo</author>
        <description><![CDATA[IntroductionSickle Cell Disease (SCD) ranks among the most prevalent genetic disorders globally. The incidence in sub-Saharan African countries has been estimated to be 230.000/y with a high prevalence (1%) in the Democratic Republic of Congo (DRC). Stroke is a significant complication of Sickle Cell Disease (SCD), and carries a high risk of disability and mortality. Transcranial Doppler (TCD) is currently the non-invasive exploration recommended for the prevention of stroke in young SCD patients.ObjectiveTo determine the prevalence of pathological TCD in a population of young Congolese SCA patients and to assess its association with hematological parameters.Population and methodsThis cross sectional study was carried out on 150 Congolese SS homozygous children between the ages 2–16 years old (mean age: 8.5 ± 4.0 years) in stable condition, and followed from January 1 to December 31, 2013. TCD was performed using the STOP I method in the main cerebral arteries. The risk of stroke was absent when the average maximum speed during a cycle (TAMMV) in middle cerebral artery (MCA) was < 170 cm/s, but present when TAMMV was borderline or conditional for values between 170 and 199 cm/s and pathological for values ≥ 200 cm/s.ResultsThe prevalence of pathological TCD was 4% while the conditional TCD prevalence was 10%. The Mean blood velocity in MCA was 114.0 cm/s. There was a significant difference in the means of WBC (p = 0.003), Hb (p < 0.001), Hct (p < 0.001), MCV (p = 0.005) parameters when comparing normal and at risk TCD (conditional and abnormal). However, no significant association was found for the categorical corresponding parametersConclusionGlobally, 14% of patients were at risk of stroke, hence the interest in integrating TCD in the routine monitoring of children with SCD in order to prevent overt stroke by implementing a chronic blood transfusion program or the use of hydroxycarbamide.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1368576</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1368576</link>
        <title><![CDATA[Sickle cell anemia and early stroke detection and prevention in Nigeria]]></title>
        <pubdate>2024-06-19T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Kudirat Abdulkareem Ahmed</author><author>Halima Bello-Manga</author><author>Lori C. Jordan</author>
        <description><![CDATA[Sickle cell disease (SCD) is the most common hereditary blood disorder worldwide, and sickle cell anemia (SCA), the homozygous state of SCD, is the most common and severe variant of the disease. Nigeria has the highest burden of SCA in the world. Hemolysis and vaso-occlusion can lead to a wide range of complications, including stroke which is one of the most devastating manifestations of SCA with significant morbidity and mortality. SCA remains the leading cause of stroke in black children. Without any intervention, strokes occur in approximately 11% of children with SCA before their 20th birthday, with the greatest risk in very young children between 2 and 5 years of age. In resource-constrained countries, where the burden of SCA is highest, stroke is underreported, hence the need to develop strategies for stroke prevention and early detection. Improving awareness among healthcare providers and the community can significantly reduce stroke rates and improve stroke detection. The goal of this manuscript is to discuss the progress that has been made in stroke prevention and detection in children with SCA in Nigeria and outline current challenges and future goals. We believe that our experience will be valuable not only in Nigeria which has the highest burden of SCA globally, but also in other low- and middle-income countries.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1371093</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1371093</link>
        <title><![CDATA[General ability and specific cognitive functions are lower in children with epilepsy after perinatal ischemic stroke]]></title>
        <pubdate>2024-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ulvi Vaher</author><author>Mairi Männamaa</author><author>Rael Laugesaar</author><author>Norman Ilves</author><author>Nigul Ilves</author><author>Dagmar Loorits</author><author>Pille Kool</author><author>Pilvi Ilves</author>
        <description><![CDATA[IntroductionEpilepsy develops in one third of children after perinatal stroke. Both epilepsy and stroke may be risk factors for impaired cognitive abilities. How the development of epilepsy is related to the cognitive profile of children with perinatal stroke is still unclear. The aim of the study was to evaluate general and specific cognitive functions in children with epilepsy and children without epilepsy after perinatal ischemic stroke.MethodsThe study group consisted of 51 children with perinatal ischemic stroke confirmed by magnetic resonance imaging: 27 (53%) children with arterial ischemic stroke and 24 (47%) with periventricular venous infarction. Magnetic resonance imaging and electroencephalography were performed in all patients after the neonatal period. Epilepsy was diagnosed if the child had at least two unprovoked seizures occurring >24 h apart or one unprovoked seizure with a high recurrence risk. Cognitive assessments were performed using the Kaufman Assessment Battery for Children, Second Edition, at the age of ≥7 years. General ability (Fluid Crystallized Index, Mental Processing Index, Non-verbal Index) and specific cognitive functions (sequential processing, simultaneous processing, learning, planning, knowledge) were evaluated.ResultsAt the median age of 19.3 years (interquartile range 14.0–22) at the time of follow-up for epilepsy, 14 (27.5%) patients had developed epilepsy, and 37 (72.5%) patients were without epilepsy. All general cognitive ability scores were lower in children with epilepsy compared to children without epilepsy. Among specific cognitive functions, simultaneous processing, planning, and knowledge were lower in children with epilepsy compared to children without epilepsy: simultaneous processing mean [78.5, 95% CI: [69.8, 87.2], vs. 96.9, 95% CI [90, 103.9], p = 0.0018]; planning mean [82.5, 95% CI: [73, 92], vs. 96.2, 95% CI: [88.7, 103.6], p = 0.026]; knowledge median (25th, 75th percentile): 80.5 (75, 87) vs. 92 (84, 108), p = 0.023.ConclusionChildren with epilepsy after perinatal ischemic stroke have lower general cognitive abilities compared to children without epilepsy. The profile of the subscales indicates lower verbal abilities and executive functions in children with epilepsy. Children with post-stroke epilepsy need targeted cognitive monitoring for early aimed rehabilitation and for establishing an adapted learning environment.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2024.1372949</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2024.1372949</link>
        <title><![CDATA[Neurocognitive impairment in Ugandan children with sickle cell anemia compared to sibling controls: a cross-sectional study]]></title>
        <pubdate>2024-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Paul Bangirana</author><author>Amelia K. Boehme</author><author>Annet Birabwa</author><author>Robert O. Opoka</author><author>Deogratias Munube</author><author>Ezekiel Mupere</author><author>Phillip Kasirye</author><author>Grace Muwanguzi</author><author>Maxencia Musiimenta</author><author>George Ru</author><author>Nancy S. Green</author><author>Richard Idro</author>
        <description><![CDATA[IntroductionThe neurocognitive functions in Ugandan children aged 1–12 years with sickle cell anemia (SCA) were compared to their non-SCA siblings to identify risk factors for disease-associated impairment.MethodsThis cross-sectional study of the neurocognitive functions in children with SCA (N = 242) and non-SCA siblings (N = 127) used age- and linguistically appropriate standardized tests of cognition, executive function, and attention for children ages 1–4 and 5–12. Test scores were converted to locally derived age-normalized z-scores. The SCA group underwent a standardized stroke examination for prior stroke and transcranial Doppler ultrasound to determine stroke risk by arterial flow velocity.ResultsThe SCA group was younger than their siblings (mean ages 5.46 ± 3.0 vs. 7.11 ± 3.51 years, respectively; p < 0.001), with a lower hemoglobin concentration (7.32 ± 1.02 vs. 12.06 ± 1.42, p < 0.001). The overall cognitive SCA z-scores were lower, −0.73 ± 0.98, vs. siblings, −0.25 ± 1.12 (p < 0.001), with comparable findings for executive function of −1.09 ± 0.94 vs. −0.84 ± 1.26 (p = 0.045), respectively. The attention z-scores for ages 5–12 for the SCA group and control group were similar: −0.37 ± 1.4 vs. −0.11 ± 0.17 (p = 0.09). The overall differences in SCA status were largely driven by the older age group, as the z-scores in the younger subsample did not differ from controls. Analyses revealed the strongest predictors of poor neurocognitive outcomes among the SCA sample to be the disease, age, and prior stroke (each p < 0.001). The impacts of anemia and SCA were indistinguishable.DiscussionNeurocognitive testing in children with SCA compared to non-SCA siblings revealed poorer SCA-associated functioning in children older than age 4. The results indicate the need for trials assessing the impact of disease modification on children with SCA.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2023.1197714</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2023.1197714</link>
        <title><![CDATA[Mechanisms of pediatric ischemic strokes in COVID-19: a systematic review]]></title>
        <pubdate>2023-07-03T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Elbert John V. Layug</author><author>Almira Doreen Abigail O. Apor</author><author>Rudolf V. Kuhn</author><author>Marilyn A. Tan</author>
        <description><![CDATA[BackgroundCoronavirus disease 2019 (COVID-19) has been shown to cause vasculopathic and hemostatic derangements predisposing to cerebrovascular and thrombotic disorders in adults. Data in children, however, are limited to case reports and series. Given the unique risk factors and potential pathomechanisms in children, it is imperative to characterize stroke in children with COVID-19. Understanding these mechanisms is essential in drafting an appropriate management protocol to improve outcomes in a population where stroke carries higher disability-adjusted life years.MethodsA systematic literature search was done in MEDLINE, EMBASE, Web of Science and Google Scholar using the terms “pediatric ischemic stroke,” “cerebral sinovenous thrombosis,” “SARS-CoV-2,” and “COVID-19.” Patient demographics, clinical profile, stroke risk factors, neuroimaging findings, interventions and outcomes were recorded.ResultsThe search produced 776 records. After preliminary review of titles, abstracts and selected full texts, 52 articles comprising of 74 patients were studied. The cohort has slight female predominance (51.5%), with mean age of 9.2 years (±2SD 5.6). Pediatric ischemic strokes were categorized as arterial ischemic strokes (82.40%), cerebral sinovenous thrombosis (12.20%) and combined arterial and venous strokes (5.41%). Mechanisms of ischemic stroke included thrombophilia (47.3%), vasculopathies (27%) and cardioembolism (6.8%). Twenty cases (27%) had comorbidities predisposing to stroke and only 18.9% met the criteria for multisystem inflammatory syndrome in children (MIS-C). Outcomes ranged from complete recoveries (13/58), residual deficits (35/58), and mortalities (10/58).ConclusionThis study presents a comprehensive summary of the currently available published literature on pediatric ischemic strokes in the background of COVID-19. The clinical profiles and outcomes of patients reviewed support prior hypotheses that the virus can cause both a vasculopathy and induce a derangement in the coagulation system, predisposing to ischemic strokes.Study registrationThis paper's protocol has been registered in PROSPERO with ID number CRD42022315219.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fstro.2023.1204718</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fstro.2023.1204718</link>
        <title><![CDATA[Grand challenges in pediatric stroke]]></title>
        <pubdate>2023-05-19T00:00:00Z</pubdate>
        <category>Specialty Grand Challenge</category>
        <author>Natalie Ullman</author><author>Daniel J. Licht</author>
        <description></description>
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