AUTHOR=Luckman Judith , Chokron Sylvie , Michowiz Shalom , Belenky Eugenia , Toledano Helen , Zahavi Alon , Goldenberg-Cohen Nitza 

TITLE=The Need to Look for Visual Deficit After Stroke in Children

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00617

DOI=10.3389/fneur.2020.00617

ISSN=1664-2295

ABSTRACT=<p><bold>Purpose:</bold> To evaluate the role of the ophthalmologist in the management of children with arterial stroke, at presentation and during follow-up.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> The cohort included 26 children with stroke. Underlying disorders included metabolic syndrome (<italic>n</italic> = 5, 19.2%), cardiac anomaly or Fontan repair (<italic>n</italic> = 3 each, 11.5%), vascular anomaly (<italic>n</italic> = 3, 11.5%), head trauma with traumatic dissection (<italic>n</italic> = 3, 11.5%), and hypercoagulability (<italic>n</italic> = 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.</p><p><bold>Conclusion:</bold> 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.</p>