The prevalence of genetic and functional coagulation abnormalities in 59 children (age 0-18 years) with arterial ischemic stroke or porencephaly was compared with previously published population frequencies in a study at the National Institute for Neurological Disorders and Stroke, Bethesda, MD. Two thirds had at least 1 prothrombotic risk factor, and 5 had 3 or more. A family history of early thrombosis was found in one third of the children with coagulopathies and stroke. Abnormal factors included plasminogen activator inhibitor-1, methylenetetrahydrofolate reductase (involved in homocysteine metabolism), elevated lipoprotein (a), activated PC resistance, and factor V. Prothrombotic abnormalities are common in cerebrovascular disorders in children. [1]

COMMENT. Previous studies of coagulation abnormalities in children with stroke have shown variable results. The above findings support prothrombotic screening. Common risk factors for stroke have included cerebral arterial abnormalities, previous varicella zoster infection, preceding trauma, recent infection, and anemia (Ped Neur Briefs Feb 2003; 17:15). [2]