Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;35(2):295-300.
doi: 10.1007/s00381-018-4021-5. Epub 2018 Dec 8.

Age-associated hippocampal volume changes in childhood arterial ischemic stroke

Zak Ritchey  1 , David M Mirsky  2 , David Weitzenkamp  3 , Timothy J Bernard  4 , Paco S Herson  5 , Nicholas V Stence  6
Affiliations

Age-associated hippocampal volume changes in childhood arterial ischemic stroke

Zak Ritchey et al. Childs Nerv Syst. 2019 Feb.

Abstract

Purpose: Recent evidence suggests that recovery from secondary neurodegeneration following arterial ischemic stroke (AIS) may be related to age at injury and site of occlusion. We conducted a study of hippocampal volume (HCV) in a cohort of pediatric patients with middle cerebral artery (MCA) territory AIS to determine whether HCV would be preserved in younger children as compared to older children.

Methods: This single-center, HIPAA-compliant retrospective study was approved by the institutional review board. The medical records of 149 children treated for AIS between 2000 and 2016 were reviewed for inclusion criteria: unilateral MCA territory AIS and availability of high-resolution T1-weighted MR imaging at both acute and chronic time periods. Manual segmentation was utilized to measure stroke-side HCV, contralateral HCV, hemispheric volumes, and stroke volume on each scan. To correct for variable brain size, HCV measurements were ratio normalized. Patients were divided into two age-at-stroke groups: younger (30 days-9 years old) and older (> 9-18 years old). Analysis was performed using Fisher's test or Student's t test.

Results: The MR imaging of 19 children (9 younger, 10 older) was analyzed. At follow-up, the average stroke-side HCV increased by 10.9% in the younger group and decreased by 6.3% in the older group (P = 0.010); this between-group difference remained significant even when ratio normalized (P = 0.003). The total brain volume-adjusted acute stroke size between groups was not statistically different (P = 0.649).

Conclusions: In children with AIS, younger age is associated with the relative preservation of HCV, which could reflect differences in age-related plasticity.

Keywords: Arterial ischemic stroke; Hippocampal volume; Magnetic resonance imaging; Pediatric stroke.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Post-stroke hippocampal changes across the pediatric age spectrum. Acute and chronic HCVR are represented by the arrow base and the arrow tip, respectively. Comparing relative stroke-side HCV, children with AIS occurring before age 9 demonstrated a trend towards growth (black arrows), while older children with stroke exhibited a trend towards loss (gray arrows)
Fig. 2
Fig. 2
Representative images from a 17-year-old male who suffered a right MCA territory AIS. Acute imaging performed 2 days after presentation demonstrates gyral edema on coronal T1 images (a) that matured into cystic encephalomalacia on MRI performed at 3-month follow-up (b). Three-dimensional volume rendered images of the right hippocampal segmentation performed on the acute (c) and follow-up (d) exams show loss of stroke-side HCVover time
See this image and copyright information in PMC

References

    1. Xie M, Yi C, Luo X, Xu S, Yu Z, Tang Y, Zhu W, Du Y, Jia L, Zhang Q, Dong Q, Zhu W, Zhang X, Bu B, Wang W (2011) Glial gap junctional communication involvement in hippocampal damage after middle cerebral artery occlusion. Ann Neurol 70(1):121–132. 10.1002/ana.22386 - DOI - PubMed
    1. Tang X, Wang C, Xia L, Zhu W, Zhao L, Zhu W (2012) Volumetric MRI and 1H MRS study of hippocampus in unilateral MCAO patients: relationship between hippocampal secondary damage and cognitive disorder following stroke. Eur J Radiol 81(10): 2788–2793. 10.1016/j.ejrad.2011.08.010 - DOI - PubMed
    1. Max JE, Bruce M, Keatley E, Delis D (2010) Pediatric stroke: plasticity, vulnerability, and age of lesion onset. J Neuropsychiatry Clin Neurosci 22(1):30–39. 10.1176/jnp.2010.22.1.30 - DOI - PubMed
    1. Westmacott R, Askalan R, Macgregor D, Anderson P, Deveber G (2010) Cognitive outcome following unilateral arterial ischaemic stroke in childhood: effects of age at stroke and lesion location. Dev Med Child Neurol 52(4):386–393. 10.1111/j.1469-8749.2009.03403.x - DOI - PubMed
    1. Orfila JE, Grewal H, Bernard TJ, Macklin WB, Traystman RJ, Herson PS (2015) Neurophysiological responses of recovery in pediatric mice compared to adult mice with transient focal cerebral ischemia. [abstract]. Stroke 46:A19–A19

LinkOut - more resources