The Need to Look for Visual Deficit After Stroke in Children
Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical cent...
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| Published in: | Frontiers in neurology Vol. 11; p. 617 |
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02.07.2020
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| Abstract | Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical center in 2005-2016. Demographic data and findings on radiological neuroimaging and ophthalmological and neurological examination were retrieved from the medical files. Results: The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (n = 5, 19.2%), cardiac anomaly or Fontan repair (n = 3 each, 11.5%), vascular anomaly (n = 3, 11.5%), head trauma with traumatic dissection (n = 3, 11.5%), and hypercoagulability (n = 1, 3.8%); in eight patients (30.8%), no apparent cause was found. Eleven patients (42.3%) had a non-ophthalmological neurological deficit as a result of the stroke. Eye examination was performed in nine patients (34.6%) during follow-up. Ophthalmological manifestations included hemianopic visual field defect in seven patients (7.7%) and complete blindness and poor visual acuity in one patient each (3.8%). At the last visit, no change in visual function was detected. Conclusion: The variable etiology and presentation of pediatric stroke may mask specific visual signs. Children with arterial stroke should be referred for early ophthalmological evaluation and visual rehabilitation.Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical center in 2005-2016. Demographic data and findings on radiological neuroimaging and ophthalmological and neurological examination were retrieved from the medical files. Results: The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (n = 5, 19.2%), cardiac anomaly or Fontan repair (n = 3 each, 11.5%), vascular anomaly (n = 3, 11.5%), head trauma with traumatic dissection (n = 3, 11.5%), and hypercoagulability (n = 1, 3.8%); in eight patients (30.8%), no apparent cause was found. Eleven patients (42.3%) had a non-ophthalmological neurological deficit as a result of the stroke. Eye examination was performed in nine patients (34.6%) during follow-up. Ophthalmological manifestations included hemianopic visual field defect in seven patients (7.7%) and complete blindness and poor visual acuity in one patient each (3.8%). At the last visit, no change in visual function was detected. Conclusion: The variable etiology and presentation of pediatric stroke may mask specific visual signs. Children with arterial stroke should be referred for early ophthalmological evaluation and visual rehabilitation. |
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| AbstractList | Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical center in 2005–2016. Demographic data and findings on radiological neuroimaging and ophthalmological and neurological examination were retrieved from the medical files. Results: The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (n = 5, 19.2%), cardiac anomaly or Fontan repair (n = 3 each, 11.5%), vascular anomaly (n = 3, 11.5%), head trauma with traumatic dissection (n = 3, 11.5%), and hypercoagulability (n = 1, 3.8%); in eight patients (30.8%), no apparent cause was found. Eleven patients (42.3%) had a non-ophthalmological neurological deficit as a result of the stroke. Eye examination was performed in nine patients (34.6%) during follow-up. Ophthalmological manifestations included hemianopic visual field defect in seven patients (7.7%) and complete blindness and poor visual acuity in one patient each (3.8%). At the last visit, no change in visual function was detected. Conclusion: The variable etiology and presentation of pediatric stroke may mask specific visual signs. Children with arterial stroke should be referred for early ophthalmological evaluation and visual rehabilitation. Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical center in 2005-2016. Demographic data and findings on radiological neuroimaging and ophthalmological and neurological examination were retrieved from the medical files. Results: The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (n = 5, 19.2%), cardiac anomaly or Fontan repair (n = 3 each, 11.5%), vascular anomaly (n = 3, 11.5%), head trauma with traumatic dissection (n = 3, 11.5%), and hypercoagulability (n = 1, 3.8%); in eight patients (30.8%), no apparent cause was found. Eleven patients (42.3%) had a non-ophthalmological neurological deficit as a result of the stroke. Eye examination was performed in nine patients (34.6%) during follow-up. Ophthalmological manifestations included hemianopic visual field defect in seven patients (7.7%) and complete blindness and poor visual acuity in one patient each (3.8%). At the last visit, no change in visual function was detected. Conclusion: The variable etiology and presentation of pediatric stroke may mask specific visual signs. Children with arterial stroke should be referred for early ophthalmological evaluation and visual rehabilitation.Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This retrospective case series comprised children with arterial stroke who were followed for at least 12 months in a tertiary pediatric medical center in 2005-2016. Demographic data and findings on radiological neuroimaging and ophthalmological and neurological examination were retrieved from the medical files. Results: The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (n = 5, 19.2%), cardiac anomaly or Fontan repair (n = 3 each, 11.5%), vascular anomaly (n = 3, 11.5%), head trauma with traumatic dissection (n = 3, 11.5%), and hypercoagulability (n = 1, 3.8%); in eight patients (30.8%), no apparent cause was found. Eleven patients (42.3%) had a non-ophthalmological neurological deficit as a result of the stroke. Eye examination was performed in nine patients (34.6%) during follow-up. Ophthalmological manifestations included hemianopic visual field defect in seven patients (7.7%) and complete blindness and poor visual acuity in one patient each (3.8%). At the last visit, no change in visual function was detected. Conclusion: The variable etiology and presentation of pediatric stroke may mask specific visual signs. Children with arterial stroke should be referred for early ophthalmological evaluation and visual rehabilitation. |
| Author | Zahavi, Alon Chokron, Sylvie Luckman, Judith Michowiz, Shalom Goldenberg-Cohen, Nitza Belenky, Eugenia Toledano, Helen |
| AuthorAffiliation | 4 Pediatric Oncology, Schneider Children's Medical Center of Israel , Petach Tikva , Israel 6 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel 7 Krieger Eye Research Laboratory, Felsenstein Medical Research Center, Rabin Medical Center , Petach Tikva , Israel 1 Department of Radiology, Rabin Medical Center – Beilinson Hospital , Petach Tikva , Israel 2 Responsable de l'Unité Fonctionnelle Vision et Cognition Service de Neurologie Fondation Ophtalmologique Rothschild , Paris , France 3 Department of Neurosurgery, Hadassah Hebrew University , Jerusalem , Israel 5 Department of Ophthalmology, Rabin Medical Center – Beilinson Hospital , Petach Tikva , Israel 9 Faculty of Medicine, Technion – Israel Institute of Technology , Haifa , Israel 8 Department of Ophthalmology, Bnai Zion Medical Center , Haifa , Israel |
| AuthorAffiliation_xml | – name: 1 Department of Radiology, Rabin Medical Center – Beilinson Hospital , Petach Tikva , Israel – name: 9 Faculty of Medicine, Technion – Israel Institute of Technology , Haifa , Israel – name: 3 Department of Neurosurgery, Hadassah Hebrew University , Jerusalem , Israel – name: 5 Department of Ophthalmology, Rabin Medical Center – Beilinson Hospital , Petach Tikva , Israel – name: 6 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel – name: 4 Pediatric Oncology, Schneider Children's Medical Center of Israel , Petach Tikva , Israel – name: 7 Krieger Eye Research Laboratory, Felsenstein Medical Research Center, Rabin Medical Center , Petach Tikva , Israel – name: 8 Department of Ophthalmology, Bnai Zion Medical Center , Haifa , Israel – name: 2 Responsable de l'Unité Fonctionnelle Vision et Cognition Service de Neurologie Fondation Ophtalmologique Rothschild , Paris , France |
| Author_xml | – sequence: 1 givenname: Judith surname: Luckman fullname: Luckman, Judith – sequence: 2 givenname: Sylvie surname: Chokron fullname: Chokron, Sylvie – sequence: 3 givenname: Shalom surname: Michowiz fullname: Michowiz, Shalom – sequence: 4 givenname: Eugenia surname: Belenky fullname: Belenky, Eugenia – sequence: 5 givenname: Helen surname: Toledano fullname: Toledano, Helen – sequence: 6 givenname: Alon surname: Zahavi fullname: Zahavi, Alon – sequence: 7 givenname: Nitza surname: Goldenberg-Cohen fullname: Goldenberg-Cohen, Nitza |
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| CitedBy_id | crossref_primary_10_3389_fnhum_2022_727565 crossref_primary_10_1007_s10633_025_10020_7 |
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| Copyright | Copyright © 2020 Luckman, Chokron, Michowiz, Belenky, Toledano, Zahavi and Goldenberg-Cohen. Copyright © 2020 Luckman, Chokron, Michowiz, Belenky, Toledano, Zahavi and Goldenberg-Cohen. 2020 Luckman, Chokron, Michowiz, Belenky, Toledano, Zahavi and Goldenberg-Cohen |
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| References | Mirabelli-Badenier (B2) 2012; 42 Lynch (B1) 2004; 4 Zihl (B11) 1995; 33 Roach (B18) 2008; 39 Harbert (B20) 2012; 107 Roach (B5) 2000; 7 Chokron (B15) 2016; 7 Lueck (B12) 2015 Zhang (B10) 2006; 66 Ganesan (B16) 2000; 42 Kedar (B14) 2006; 10 Kieslich (B23) 2002; 73 Zhang (B9) 2006; 26 Monagle (B17) 2008; 133 deVeber (B4) 2000; 7 Brankovic-Sreckovic (B7) 2004; 13 Roach (B6) 2000; 2 Chokron (B22) 2016; 10 Zhang (B8) 2006; 66 Dowling (B19) 2013; 39 Sand (B13) 2013; 196 Chokron (B21) 2015 Tsze (B3) 2011; 2011 |
| References_xml | – volume: 2 start-page: 295 year: 2000 ident: B6 article-title: Stroke in children publication-title: Curr Treat Options Neurol doi: 10.1007/s11940-000-0047-5 – volume: 7 start-page: 244 year: 2000 ident: B5 article-title: Etiology of stroke in children publication-title: Semin Pediatr Neurol doi: 10.1053/spen.2000.20078 – volume: 4 start-page: 129 year: 2004 ident: B1 article-title: Cerebrovascular disorders in children publication-title: Curr Neurol Neurosci Rep doi: 10.1007/s11910-004-0027-3 – volume: 42 start-page: 455 year: 2000 ident: B16 article-title: Outcome after ischaemic stroke in childhood publication-title: Dev Med Child Neurol doi: 10.1017/S0012162200000852 – volume: 26 start-page: 180 year: 2006 ident: B9 article-title: Homonymous hemianopia in stroke publication-title: J Neuroophthalmol doi: 10.1097/01.wno.0000235587.41040.39 – volume: 13 start-page: 153 year: 2004 ident: B7 article-title: The recurrence risk of ischemic stroke in childhood publication-title: Med Princ Pract. doi: 10.1159/000076955 – volume: 10 start-page: 57 year: 2016 ident: B22 article-title: Behavioral consequences and cortical reorganization in homonymous hemianopia publication-title: Front Syst Neurosci doi: 10.3389/fnsys.2016.00057 – volume: 7 start-page: 309 year: 2000 ident: B4 article-title: Stroke in children: recognition, treatment, and future directions publication-title: Semin Pediatr Neurol doi: 10.1053/spen.2000.20074 – volume: 39 year: 2013 ident: B19 article-title: International paediatric stroke study group. international paediatric stroke study: stroke associated with cardiac disorders publication-title: Int J Stroke. doi: 10.1111/j.1747-4949.2012.00925.x – volume: 2011 start-page: 734506 year: 2011 ident: B3 article-title: Pediatric stroke: a review publication-title: Emerg Med Int doi: 10.1155/2011/734506 – volume: 66 start-page: 906 year: 2006 ident: B10 article-title: Homonymous hemianopias: clinical-anatomic correlations in 904 cases publication-title: Neurology doi: 10.1212/01.wnl.0000203913.12088.93 – volume: 33 start-page: 287 year: 1995 ident: B11 article-title: Visual scanning behavior in patients with homonymous hemianopia publication-title: Neuropsychologia doi: 10.1016/0028-3932(94)00119-A – volume: 107 start-page: 545 year: 2012 ident: B20 article-title: Unrecognized visual field deficit in children with primary central nervous system brain tumors publication-title: J Neurooncol doi: 10.1007/s11060-011-0774-3 – volume-title: Impairment of Vision Due to Disorders of the Visual Brain in Childhood: A Practical Approach year: 2015 ident: B21 article-title: Evaluation of visuo-spatial abilities (EVA): a simple and rapid battery to screen for CVI in young children – volume: 7 start-page: 1471 year: 2016 ident: B15 article-title: Impact of cerebral visual impairments on motor skills: implications for developmental coordination disorders publication-title: Front Psychol doi: 10.3389/fpsyg.2016.01471 – volume: 196 start-page: 52 year: 2013 ident: B13 article-title: Visual impairment in stroke patients–a review publication-title: Acta Neurol Scand Suppl doi: 10.1111/ane.12050 – volume: 42 start-page: 784 year: 2012 ident: B2 article-title: Pathophysiological role of inflammatory molecules in paediatric ischaemic brain injury publication-title: Eur J Clin Invest doi: 10.1111/j.1365-2362.2012.02640.x – volume: 66 start-page: 901 year: 2006 ident: B8 article-title: Natural history of homonymous hemianopia publication-title: Neurology doi: 10.1212/01.wnl.0000203338.54323.22 – volume: 133 start-page: 887S year: 2008 ident: B17 article-title: Antithrombotic therapy in neonates and children: American college of chest physicians evidence-based clinical practice guidelines (8th edition) publication-title: Chest doi: 10.1378/chest.08-0762 – volume: 73 start-page: 13 year: 2002 ident: B23 article-title: Minor head injury as cause and co-factor in the aetiology of stroke in childhood: a report of eight cases publication-title: J Neurol Neurosurg Psychiatry doi: 10.1136/jnnp.73.1.13 – volume: 10 start-page: 249 year: 2006 ident: B14 article-title: Pediatric homonymous hemianopia publication-title: J AAPOS doi: 10.1016/j.jaapos.2006.01.181 – volume: 39 start-page: 2644 year: 2008 ident: B18 article-title: American Heart association stroke council; council on cardiovascular disease in the young. management of stroke in infants and children: a scientific statement from a special writing group of the American heart association stroke council and the council on cardiovascular disease in the young publication-title: Stroke. doi: 10.1161/STROKEAHA.108.189696 – volume-title: Vision and the Brain: Understanding Cerebral Visual Impairment in Children. year: 2015 ident: B12 |
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| Snippet | Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up. Methods: This... Purpose: To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up.Methods: This... |
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| SubjectTerms | arterial stroke children cortical visual impairment eye exam Neurology ophthalmological complication |
| Title | The Need to Look for Visual Deficit After Stroke in Children |
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