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Gorodetsky C, Pulcine E, Krishnan P, Singh J, Moharir M, MacGregor D, Bhathal I, deVeber G, Dlamini N. Childhood arterial ischemic stroke due to mineralizing angiopathy: an 18-year single-center experience. Dev Med Child Neurol 2021; 63:1123-1126. [PMID: 33959946 DOI: 10.1111/dmcn.14903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Carolina Gorodetsky
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Elizabeth Pulcine
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jaspal Singh
- Neurology Department, Southampton Children's Hospital, Southampton, UK
| | - Mahendranath Moharir
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daune MacGregor
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ishvinder Bhathal
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Gabrielle deVeber
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nomazulu Dlamini
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
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