Mild Infection and Stroke in Children

Minor Infections May Increase Stroke Risk in Children


According to the recent analysis, the risk is highest during the 3 days following a doctor's visit for an infection in a children, after which it rapidly diminishes. This suggests that an infection has an acute and powerful effect on stroke risk that is very transient in children.


Minor Infections



The rate of infection before the stroke or index date was greater for cases than controls in each of 3 time periods: within 3 days, 4 to 7 days, and 8 to 30 days in children. After adjustment for these periods, sex, immunologic, hematologic, and cardiac disease, and head and neck trauma in the preceding month, a diagnosis of infection 3 days before a stroke conferred a 12-fold increased risk for arterial ischemic stroke .

The risk rapidly diminished after those 3 days, with no increased risk for stroke beyond 1 week.

The cause may be the infection-related activation of the coagulation cascade rather than arterial injury. Circulating inflammatory factors increase the risk for blood clots and possibly cause inflammation of the lining of the heart or blood vessels leading to the brain.

It also might have something to do with exposure to cold remedies containing vasoactive ingredients or mechanical forces leading to cervical arterial dissection. "If your blood vessels are inflamed and you have some sort of minor trauma like coughing or sneezing or play wrestling or diving into a pool, the vessels are just a bit more prone to injury.

The important message is that infection can be a trigger in children who are otherwise predisposed to stroke. "In some case, they are otherwise predisposed in ways we understand, like children who have congenital heart disease or sickle cell disease, but in other cases, they're predisposed in ways we don't understand," although genetics could play a role.



Overall, about 15% of children with stroke will go on to have a recurrence but in those with abnormalities of blood vessels to the brain, the recurrence rate of over 50%.

Vaccinations may be an avenue toward avoiding stroke. In a large international prospective study of infection in childhood stroke, some results of which were presented earlier this year. Vaccinations are protective against childhood stroke. They also found that herpes infections are quite common in children with stroke, which is important because these infections can be treated with, for example, the antiviral acyclovir.

"This is one more reason that vaccination programs and good hygiene are so important in preventing infection in children.

And although aspirin, a mild blood thinner, has been linked to Reye's syndrome,.May be aspirin isn't such a bad idea in kids with an infection, adding that this idea is "certainly preliminary."

But also important is for parents — and physicians — to recognize that stroke really does happen to children.