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Age-associated hippocampal volume changes in childhood arterial ischemic stroke

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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.

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Funding

This study was funded by the American Heart Association Predoctoral Fellowship to Z.R. (Award 15PRE25550151), the American Stroke Association/Bugher Foundation Stroke Collaborative Research Center (Grant 14BFSC17540000), and the Maternal and Child Health Bureau 340B Program at the Mountain States Hemophilia and Thrombosis Center.

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Authors and Affiliations

  1. Department of Internal Medicine, University of California Irvine, Orange, CA, USA

    Zak Ritchey

  2. Department of Radiology, Children’s Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA

    David M. Mirsky & Nicholas V. Stence

  3. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA

    David Weitzenkamp

  4. Section of Child Neurology, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA

    Timothy J. Bernard

  5. Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA

    Paco S. Herson

Authors
  1. Zak Ritchey
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  2. David M. Mirsky
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  3. David Weitzenkamp
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  4. Timothy J. Bernard
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  5. Paco S. Herson
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  6. Nicholas V. Stence
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Corresponding author

Correspondence to Nicholas V. Stence.

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Ritchey, Z., Mirsky, D.M., Weitzenkamp, D. et al. Age-associated hippocampal volume changes in childhood arterial ischemic stroke. Childs Nerv Syst 35, 295–300 (2019). https://doi.org/10.1007/s00381-018-4021-5

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  • DOI: https://doi.org/10.1007/s00381-018-4021-5

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