The Utility of Infarct Volume Measurement in Pediatric Ischemic Stroke

Abstract

This study aims to determine if stroke volume as measured on diffusion-weighted imaging is associated with neurologic outcome in children with acute arterial ischemic stroke. A cohort of patients presenting to a tertiary care children's hospital with acute ischemic stroke were studied. The relationship between stroke volume, clinical characteristics, and neurologic outcome utilizing the Glasgow Outcome Scale were analyzed. In children with poor outcome, the median volume of infarction on diffusion-weighted imaging was larger when compared with children who had a good outcome. Children with stroke volume >10% of total brain volume were more likely than patients with stroke volume <5% total brain volume to have a poor outcome. Seizures were associated with a 10.5-fold increase in the risk of a poor outcome. Stroke volume, in conjunction with clinical characteristics, can assist practitioners in identifying a subset of patients with acute ischemic stroke who might benefit from aggressive medical and/or surgical management.