RT Journal Article SR Electronic T1 A right-to-left shunt in children with arterial ischaemic stroke JF Archives of Disease in Childhood JO Arch Dis Child FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 461 OP 467 DO 10.1136/adc.2010.203992 VO 96 IS 5 A1 Mirjana Perkovič Benedik A1 Marjan Zaletel A1 Nuška Pečarič Meglič A1 Tomaž Podnar YR 2011 UL http://adc.bmj.com/content/96/5/461.abstract AB Objective To compare the prevalence and grade of right-to-left shunt (RLS) in children with arterial ischaemic stroke (AIS) and in controls. Design Prospective study. Setting Tertiary paediatric referral centre. Patients 30 consecutive children with AIS. Intervention Contrast transcranial Doppler (cTCD) with Valsalva manoeuvre was performed in children with AIS and in controls. Main outcome measures Detection and quantification of RLS. Results Logistic regression analysis showed that RLS was significantly associated with AIS and prothrombotic disorders or with AIS of undetermined aetiology (OR 6.10; 95% CI 1.41 to 26.3; p=0.015). The prevalence of RLS was significantly higher in a group of children with AIS and prothrombotic disorders or with AIS of undetermined aetiology compared to controls (p<0.05). Significantly more microembolic signals (MES) were detected in a group of children with AIS and prothrombotic disorders or with AIS of undetermined aetiology than in controls (p<0.005). Conclusions Both the prevalence of RLS and number of detected MES were significantly higher in a group of children with AIS and prothrombotic disorders or with AIS of undetermined aetiology compared to controls. These findings suggest that paradoxical embolism may be an underestimated cause of AIS in children, particularly those with AIS and prothrombotic disorders or with AIS of undetermined aetiology.