Background: A stroke in children is rare. Congenital or acquired cardiac disease is the most common cause of pediatric strokes, accounting for 1/3 of all AIS (Acute Ischemic Stroke). AIS may result from thrombotic vessel occlusion, dissection, Moyamoya, vasculitis, post-varicella arteriopathy and trauma.
We aim at increasing the awareness of a possible heart disease underlying childhood stroke.
We describes a 3 years-old girl with a cerebellar ischemic stroke as the presenting symptom of an isolated aortic-coarctation, with no other underlying condition predisposing to stroke.
Result: Among the cardiac conditions that predispose to AIS are cardiac repair, catheterization, cyanotic lesions with polycythemia /anemia. Embolic clots may occur in cardiomyopathies, rheumatic heart disease, prosthetic valves, vegetation or via PFO
In most patients, cardiac disease is diagnosed before the stroke. In a large series, 7% of ischemic and 2% of hemorrhagic childhood strokes were attributable to congenital heart disease. Cardiac surgery resulted in the greatest risk for stroke, beyond the immediate postoperative-period. Stroke has been associated with most types of cardiac disease but those with cyanotic and complex congenital heart disease appeared to be at greatest risk.
Discussion: To the best of our knowledge, this is the first documented case of an isolated aortic-coarctation without PHACE syndrome causing AIS.
Conclusion: The diagnosis of childhood stroke is challenging and investigation should include searching for cardiac etiology.
