Iron deficiency: A cause of stroke in infants and children

doi:10.1016/S0887-8994(96)00290-1

Pediatric Neurology

Volume 16, Issue 1, January 1997, Pages 50-53

https://doi.org/10.1016/S0887-8994(96)00290-1 Get rights and content

Abstract

Iron deficiency is a common pediatric problem affecting 20%–25% of the world's infants. Most commonly causing anemia, iron deficieny is also implicated in such neurologic sequelae as irritability, lethargy, headaches. developmental delay, and infrequently papilledema, pseudotumor cerebri, and cranial nerve abnormalities. Rarely has iron deficiency been recognized as a significant cause of stroke in the adult or pediatric populations. We report a series of 6 children, 6 to 18 months of age, who presented with an ischemic stroke or venous thrombosis after a viral prodrome. All patients had iron deficiency as a consistent finding among the group, and other known etiologies of childhood stroke were excluded. These patients provide evidence of a strong association between iron deficiency and ischemic events in children between 6 and 18 months of age.

References (14)

C.S. Bruggers et al.
Reversible focal neurologic deficits in severe iron deficiency anemia
J Pediatr
(1990)
S. Karpatkin et al.
Role of iron as a regulator of thrombopoiesis
Am J Med
(1974)
A.L. Belman et al.
Cerebral venous thrombosis in a child with iron deficiency anemia and thrombocytosis
Stroke
(1990)
G.A. Deveber
Canadian Pediatric Ischemic Stroke Study Group. Canadian Pediatric Ishemic Stroke Registry
Can J Neurol Sci
(1994)
B.S. Schoenberg et al.
Cerebrovascular disease in infants and children: A study on incidence, clinical features, and survival
Neurology
(1978)
G. Stehle et al.
Noninfectious thrombosis of the superior sagittal sinus in a patient with iron deficiency anemia
Stroke
(1990)
R.S.K. Young et al.
Severe anemia in childhood presenting as transient ischemic attacks
Stroke
(1983)

There are more references available in the full text version of this article.

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Orignal articleIron deficiency: A cause of stroke in infants and children

Abstract

J Pediatr

Am J Med

Cerebral venous thrombosis in a child with iron deficiency anemia and thrombocytosis

Stroke

Canadian Pediatric Ischemic Stroke Study Group. Canadian Pediatric Ishemic Stroke Registry

Can J Neurol Sci

Cerebrovascular disease in infants and children: A study on incidence, clinical features, and survival

Neurology

Noninfectious thrombosis of the superior sagittal sinus in a patient with iron deficiency anemia

Stroke

Severe anemia in childhood presenting as transient ischemic attacks

Stroke

Orignal article
Iron deficiency: A cause of stroke in infants and children