Inclusion and Exclusion Criteria: International Paediatric Stroke Study (IPSS)

Inclusion Criteria

A patient will be eligible for the study if s/he meets all of the following criteria for each stroke type:

AIS

  • Age: term birth (gestation ≥ 36 weeks) to 18 years
  • Event diagnosed after Jan. 1, 2003
  • Must have both clinical and radiological evidence present
    • Focal neurological deficit of acute onset lasting greater than 20 minutes and computed tomography (CT) or magnetic resonance imaging (MRI) showing infarct in location consistent with neurological signs and symptoms
    • Neonates: seizures or lethargy alone may be the only acute symptom and CT or MRI showing infarct
    • Haemorrhagic infarction (ischemic infarct with secondary haemorrhage)
    • Hypoxic ischemic event with diffuse or bilateral infarction, if there is in addition a definite focal, single arterial infarct in a specified vascular territory (e.g. middle cerebral artery, or MCA, mentioned in the radiographic report)

CSVT

  • Age: birth (premature infants included) to 18 years
  • Event diagnosed after Jan. 1, 2003
  • Must have both clinical and radiological evidence present
  • Clinical criteria: any transient neurological dysfunction including
    • headache, seizure, decreased level of consciousness
    • focal neurological signs consistent with CSVT
  • Neuroimaging criteria: thrombosis of cerebral veins or venous sinuses seen on MRI, MR venography, CT venography

    Note: For older infants and children CT alone if definite is acceptable, but not for neonates younger than 1 month of age.

Cerebrovascular condition other than CSVT/AIS

  • Presumed pre/perinatal ischemic stroke (PPIS): infants and children whose stroke is presumed to have occurred in the prenatal or perinatal period. These patients have a normal developmental history up until about 4-8 months of age, when they present with early hand preference or hemiparesis. Neuroimaging shows an old infarct.
  • IPSS only apply the term TIA (transient ischemic attack) to transitory (less than 24 hours) neurological deficit of vascular origin with no visible (new) infarct on neuroimaging.
  • Arteritis, vasculitis, vasculopathy, moya-moya with no clinical events or TIA only

Exclusion Criteria

  • Cerebral haemorrhage not associated with ischemic infarct
  • Hypoxic ischemic event with diffuse or bilateral infarction alone (not associated with one of the above conditions)

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