Children who have had infections, such as upper respiratory infections, or who have not received their scheduled vaccinations have a higher risk for stroke, according to research published September 30 online ahead of print in Neurology. 

Heather J. Fullerton, MD, and colleagues analyzed data on 355 children aged 29 days to 18 years who had had an arterial ischemic stroke and 354 children who had not had a stroke. The children were enrolled in an international case-control study (The Vascular Effects of Infection in Pediatric Stroke). Of the children who had had a stroke, 18% had infections during the week before their strokes, compared with 3% of children in the control group. The researchers determined a 6.3-fold increased risk of arterial ischemic stroke in children who had had an infection. The group also found that the children who had strokes were less likely to have received all or most of their recommended vaccinations. 

In an accompanying editorial, José Biller, MD, and Geoffrey L. Heyer, MD, wrote, “While further study is needed to clarify how infection increases stroke risk, one can speculate that the physiologic changes related to infection (systemic inflammation, dehydration, and activation of the coagulation system) could tip the balance in a child who is already at risk for stroke.” n

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