{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:35:09Z","timestamp":1789191309519,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>Focal cerebral arteriopathy (FCA)\u2014a common cause of arterial ischemic stroke in previously healthy children\u2014often progresses over days to weeks, increasing the risk of recurrent stroke. We developed a novel severity scoring system designed to quantify FCA progression and correlate with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>The VIPS study (Vascular Effects of Infection in Pediatric Stroke) prospectively enrolled 355 children with arterial ischemic stroke (2010\u20132014), including 41 with centrally confirmed FCA. Two neuroradiologists independently reviewed FCA cerebrovascular imaging, assigning a graded severity score of zero (no involvement) to 4 (occlusion) to individual arterial segments. The FCA severity score (FCASS) was the unweighted sum. In an iterative process, we modeled scores derived from different combinations of arterial segments to identify the model that optimized correlation with clinical outcome, simplicity, and reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      The optimal FCASS summed scores from 5 arterial segments: supraclinoid internal carotid artery, A1, A2, M1, and M2. The median (interquartile range) baseline FCASS was 4 (2\u20136). Of 33 children with follow-up imaging, the maximum FCASS (at any time point) was 7 (5\u20139). Twenty-four (73%) had FCA progression on follow-up with their maximum FCASS at a median of 8 (5\u201335.5) days poststroke; their median FCASS increase was 4 (2.5\u20136). FCASS did not correlate with recurrent arterial ischemic stroke. Maximum (but not baseline) FCASS correlated with 1-year pediatric stroke outcome measures (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Our novel scoring system for FCA severity correlates with neurological outcomes in the VIPS cohort and provides a tool for FCA treatment trials under development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.118.021556","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T05:14:56Z","timestamp":1539580496000},"page":"2590-2596","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":74,"title":["Focal Cerebral Arteriopathy of Childhood"],"prefix":"10.1161","volume":"49","author":[{"given":"Heather J.","family":"Fullerton","sequence":"first","affiliation":[{"name":"From the Department of Neurology (H.J.F., N.K.H.), University of California, San Francisco"},{"name":"Department of Pediatrics (H.J.F.), University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Stence","sequence":"additional","affiliation":[{"name":"Department of Radiology (N.S.), University of Colorado, Denver"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy K.","family":"Hills","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (H.J.F., N.K.H.), University of California, San Francisco"},{"name":"Department of Biostatistics and Epidemiology (N.K.H.), University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Department of Radiology, Stanford University, CA (B.J., M.W.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Amlie-Lefond","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington, Seattle (C.A.-L.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Bernard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (T.J.B.), University of Colorado, Denver"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil R.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Center for Pediatric Neurosciences, Neurological Institute, Cleveland Clinic, OH (N.R.F.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Ichord","sequence":"additional","affiliation":[{"name":"Department of Neurology, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania (R.I.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Mackay","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Royal Children\u2019s Hospital, Murdoch Children\u2019s Research Institute, University of Melbourne, Victoria, Australia (M.T.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mubeen F.","family":"Rafay","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Children\u2019s Hospital, University of Manitoba, Winnipeg, Canada (M.F.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Chabrier","sequence":"additional","affiliation":[{"name":"INSERM, UMR1059 Sainbiose, University of Lyon, CHU Saint-\u00c9tienne, France (S.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Steinlin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, University Children\u2019s Hospital, University of Bern, Switzerland (M.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S.V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY"},{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons (M.S.V.E.), Columbia University, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle A.","family":"deVeber","sequence":"additional","affiliation":[{"name":"Division of Neurology, Hospital for Sick Children, Toronto, Canada (G.A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Wintermark","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Department of Radiology, Stanford University, CA (B.J., M.W.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the VIPS 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Severity Score and Natural History"],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1161\/STROKEAHA.118.021556"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.118.021556","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]},"assertion":[{"value":"2018-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-23","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication 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