Clinical Review

Stroke Risk

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References


CHILDHOOD ARTERIAL ISCHEMIC STROKE TRIGGERS
Fullerton HJ, Hills NK, Elkind MS, et al. Infection, vaccination, and childhood arterial ischemic stroke: Results of the VIPS study. Neurology. 2015; 85(17):1459-1466.

Infection may act as a trigger for childhood arterial ischemic stroke (AIS), while routine vaccinations appear protective, according to a study of 355 patients (ages 29 days to 18 years) with AIS and 354 controls. Researchers found:
• Infection in the week prior to stroke was reported in 18% of cases versus 3% of controls, conferring a 6.3-fold increased risk for AIS.
• Upper respiratory infections were the most ­common.
• Prevalence of preceding infection was similar across arteriopathic, cardioembolic, and idiopathic stroke types.
• Use of vasoactive cold medications was similarly low in both groups.
• Children with some/few/no vaccinations were at higher stroke risk than those receiving all or most immunizations.
• In an age-adjusted model, independent risk factors for AIS included infection in the prior week, undervaccination, black race (compared to white), and rural residence.

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