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Childhood arterial ischemic stroke due to mineralizing angiopathy: an 18‐year single‐center experience
Author(s) -
Gorodetsky Carolina,
Pulcine Elizabeth,
Krishnan Pradeep,
Singh Jaspal,
Moharir Mahendranath,
MacGregor Daune,
Bhathal Ishvinder,
deVeber Gabrielle,
Dlamini Nomazulu
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14903
Subject(s) - angiopathy , medicine , basal ganglia , stroke (engine) , magnetic resonance imaging , sequela , cerebral amyloid angiopathy , infarction , pediatrics , pathology , surgery , radiology , central nervous system , endocrinology , diabetes mellitus , mechanical engineering , dementia , disease , myocardial infarction , engineering
Mineralizing angiopathy is a unique, age‐specific stroke syndrome characterized by basal ganglia infarction and lenticulostriate calcification after minor head injury in early childhood. There is limited understanding of the pathophysiology, course, and clinical outcome of this syndrome. We describe the clinical and radiographical phenotype of a single‐center, consecutively enrolled cohort of children with mineralizing angiopathy from January 2002 to January 2020 and provide a comparative analysis to previously published literature. Fourteen children were identified. Previously unreported findings include: stroke onset in eight children older than 18 months; presence of basal ganglia hemorrhage in four; multifocal basal ganglia infarcts in three; presence of additional non‐basal ganglia calcifications in three; and presence of thrombophilia in one. Seven children had moderate‐to‐severe neurological deficits. There was no symptomatic stroke recurrence (mean follow‐up 3y 7mo, SD 1y 7mo). Our expanded phenotype highlights distinct characteristics of mineralizing angiopathy in children and has the potential to inform future research.What this paper adds Children with mineralizing angiopathy are often misdiagnosed as having a limb fracture despite normal x‐rays. A magnetic resonance imaging‐only approach may miss this entity. Non‐contrast computed tomography, in addition to MRI is recommended to identify calcifications in idiopathic arterial ischemic stroke. Most children have moderate‐to‐severe neurological sequela.