{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T23:20:38Z","timestamp":1794093638734,"version":"4.8.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T00:00:00Z","timestamp":1668470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>We aimed to evaluate the percentage of posterior circulation arterial ischaemic stroke (PCAIS) caused by craniovertebral junction (CVJ) anomalies and describe their clinical course. Children admitted to a tertiary care paediatric hospital with PCAIS between July 2017 and December 2020 were assessed retrospectively for disease aetiology. We reviewed the clinical, radiological, and surgical details of children with evidence of CVJ anomalies. Fourteen (24.1%) of 58 children admitted with arterial ischaemic stroke had posterior circulation involvement. The mean age of patients presenting with posterior circulation stroke was 6\u2009years 6\u2009months (range 3\u2009months\u201315\u2009years), 11 were male. Six of 14 cases with PCAIS were due to CVJ anomaly, their ages ranged from 4\u2009months to 15\u2009years (two age ranges were noted, 4\u2009months\u20134\u2009years and 11\u201315\u2009years), four were male. Two children had atlantoaxial dislocation with basilar invagination, two had Bow Hunter syndrome with Chiari malformation type 1 (one with completed stroke), one had Chiari malformation type 1 alone, and one presented with Farber disease with proatlas segmentation anomaly in CVJ. The time lag to stroke and CVJ diagnosis ranged from 2\u2009weeks to 24\u2009months. A dynamic angiogram was required to evaluate biomechanical changes on scans with inconclusive findings on standard stroke imaging. CVJ anomalies are an important treatable cause of paediatric posterior circulation stroke. Cervical spine x\u2010ray in flexion and extension should be done in all patients with posterior circulation stroke beyond the acute period. In cryptogenic aetiology, provocative angiography with guarded neck rotation should be considered to evaluate possible dynamic vertebral artery compression.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Craniovertebral junction anomalies are an important cause of posterior circulation stroke in children.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Evidence of flat occiput, short neck, and short stature in children with posterior circulation stroke should be assessed.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Dynamic imaging helps identify dynamic vertebral artery compression.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.15462","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T07:24:38Z","timestamp":1668583478000},"page":"847-854","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cryptogenic posterior circulation stroke in children"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9704-4613","authenticated-orcid":false,"given":"Prasanthi","family":"Aripirala","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology Rainbow Children's Hospital and Perinatal Center  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8382-2741","authenticated-orcid":false,"given":"Nihaal","family":"Reddy","sequence":"additional","affiliation":[{"name":"Tenet Diagnostic Center and Rainbow Children's Hospital and Perinatal Center  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5643-2601","authenticated-orcid":false,"given":"Lokesh","family":"Lingappa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Rainbow Children's Hospital and Perinatal Center  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1332-7016","authenticated-orcid":false,"given":"Ramesh","family":"Konanki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Rainbow Children's Hospital and Perinatal Center  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandu Ravi","family":"Varma","sequence":"additional","affiliation":[{"name":"Citi Neuro Center Hospital  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subodh","family":"Raju","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Rainbow Children's Hospital and Perinatal Center  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008837"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000033092.87560.1A"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.583831"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2017.05.007"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.07.003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06337-3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410230421"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073820927108"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010416"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-01065-6_4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-008-0600-1"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-31512-6_123-1"},{"key":"e_1_2_7_14_1","first-page":"83","article-title":"Vertebrobasilar insufficiency caused by Arnold\u2010Chiari syndrome","volume":"6","author":"Shilov G N","year":"2018","journal-title":"Neurological Disorders"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100008556"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-01065-6_1"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-008-0606-8"}],"container-title":["Developmental Medicine &amp; Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.15462","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dmcn.15462","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.15462","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T14:30:24Z","timestamp":1721313024000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dmcn.15462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,15]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/dmcn.15462"],"URL":"https:\/\/doi.org\/10.1111\/dmcn.15462","archive":["Portico"],"relation":{},"ISSN":["0012-1622","1469-8749"],"issn-type":[{"value":"0012-1622","type":"print"},{"value":"1469-8749","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,15]]},"assertion":[{"value":"2022-01-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}