22. European Stroke Conference 320 Etiology of stroke and risk factors The importance of infection for arterial ischemic stroke in children I.B. Komarova1, V.P. Zykov2, L.S. Mamedova3 Russian medical academy of postgraduate education, Moscow, RUSSIAN FEDERATION1, Russian medical academy of postgraduate education, Moscow, RUSSIAN FEDERATION2, Russian medical academy of postgraduate education, Moscow, RUSSIAN FEDERATION3 Background. The arterial ischemic stroke often occurs in otherwise healthy children. The most com-mon thing in the neuroimaging is cerebral arteriopathy. Now it is suspected that the main part of the cerebral arteriopathies of childhood are caused by inflammation as a result of infection. So, the aim of our study was to evaluate the importance of infection for arterial ischemic stroke in children. Methods. 36 stroke pts (aged 4,99+/-4,15 years) were included. We performed a standardized in-terview of the parents/guardians about presence or absence of recent infection, recent febrile infec-tion, or prior chicken pox; type of infection. We examined everyone for infectious and neurological symptoms in the beginning of the stroke. We investigated data of neuroimaging and clinical blood analysis. Results. The commonplace infection during a month before stroke was indicated in 20 (55,6%) pts, chicken pox 3 month before was in 2 (5,6%) pts, the bacteremia/sepsis in the beginning of the stroke was indicated in 2 (5,6%) pts, the meningitis was accompanied of ischemic stroke in 1 (2,8%) pt. The affirmative infectious anamnesis was associated with hyperthermia, an elevated leukocyte count and a raised erythrocyte sedimentation rate in the acute stage of the stroke (F=4,88; p=0,034). Also we revealed the association between affirmative infectious anamnesis and multiple infarcts and cortical lesions (F=11,25; p=0,0019). Conclusion. The infection can be considered as the key etiological factor for arterial ischemic stroke in children in cases of multiple, mainly corti-cal, infarcts following hyperthermia, an elevated leukocyte count and a raised erythrocyte sedimen-tation rate in the acute stage. 454 © 2013 S. Karger AG, Basel Scientific Programme 321 Etiology of stroke and risk factors The incidence of deep vein thrombosis and paradoxical brain embolism in patients with acute ischemic stroke before and after the Great East Japan Earthquake R. Itabashi1, E. Furui2, S. Sato3, Y. Yazawa4, K. Kawata5, S. Fujiwara6, E. Mori7 Kohnan hospital, Sendai, JAPAN1, Kohnan hospital, Sendai, JAPAN2, Kohnan hospital, Sendai, JAPAN3, Kohnan hospital, Sendai, JAPAN4, Kohnan hospital, Sendai, JAPAN5, Kohnan hospital, Sendai, JAPAN6, Tohoku University Graduate School of Medicine, Sendai, JAPAN7 Background: It has been reported that high prevalence of deep vein thrombosis (DVT) in the refu-gees from the Great East Japan Earthquake has been reported. The aim of this study is to evaluate the change in incidence of DVT and paradoxical brain embolism in acute ischemic stroke before and after the earthquake. Methods: We retrospectively studied consecutive 993 ischemic stroke patients ( mean age 72.7 +/- 12.6 years, male 62.3%) who were admitted to our department within 7days after onset from De-cember 2009 through December 2011. Clinical characteristics, including initial NIHSS score, the incidence of DVT, and paradoxical brain embolism were compared between before and after the earthquake of March 11, 2011. The diagnosis of paradoxical brain embolism was made when all fol-lowing criteria were present: 1) brain infarction demonstrated by CT or MRI; 2) right to left shunt verified by contrast transcranial Doppler or transesophageal echocardiography; 3) Venous thrombo-sis verified by ultrasonography or enhanced CT; 4) neuroradiological features of embolism; 5) ab-sence of other sources of embolism. Results: The median of initial NIHSS score was 3 interquartile range 1-7. Eighteen patients (1.8%) were diagnosed as paradoxical brain embolism. Seventy six patients (7.6%) had DVT. The incidence of DVT and paradoxical brain embolism had increased after the earthquake (figures). In logistic regression analysis, sex female (OR9.42, 95% CI 3.01-41.5) and admission after the earth-quake (OR 2.77, 95% CI 1.06-8.07) were independently associated with paradoxical brain embo-lism. Conclusion: The incidence of DVT and paradoxical brain embolism in acute stroke patients had in-creased after the Great East Japan Earthquake.
Karger_ESC London_2013
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