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The purpose of this study was to investigate the occurrence of stroke following elective intracranial surgery at a children\u2019s hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors performed a retrospective review of all patients who developed a perioperative stroke following an elective craniotomy from 2010 through 2017. Data were collected using an institutional database that contained demographic, medical, radiological, and outcome variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 1591 elective craniotomies were performed at the authors\u2019 institution during the study period. Of these, 28 (1.8%) were followed by a perioperative stroke. Radiographic diagnosis of the infarction occurred at a median of 1.7 days (range 0\u20139 days) from the time of surgery, and neurological deficits were apparent within 24 hours of surgery in 18 patients (62.5%). Infarcts tended to occur adjacent to tumor resection sites (86% of cases), and in a unilateral (89%), unifocal (93%), and supratentorial (93%) location. Overall, 11 (39.3%) strokes were due to a perforating artery, 10 (35.7%) were due to a large vessel, 4 (14.3%) were venous, and 3 (10.7%) were related to hypoperfusion or embolic causes. Intraoperative MRI (iMRI) was used in 11 of the 28 cases, and 6 (55%) infarcts were not detected, all of which were deep.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The incidence of stroke following an elective craniotomy is low, with nearly all cases (86%) occurring after tumor resection. Perforator infarcts were most common but may be missed on iMRI.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.10.peds18491","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:52:05Z","timestamp":1551228725000},"page":"355-362","source":"Crossref","is-referenced-by-count":5,"title":["Ischemic stroke following elective craniotomy in children"],"prefix":"10.3171","volume":"23","author":[{"given":"Nickalus R.","family":"Khan","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Moore","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaafar","family":"Basma","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asim F.","family":"Choudhri","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Radiology, University of Tennessee Health Science Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandy","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Le Bonheur Children\u2019s Hospital; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Le Bonheur Children\u2019s Hospital; and"},{"name":"Semmes Murphey, Memphis, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"764","DOI":"10.3171\/2013.10.JNS131028","article-title":"Impact of preoperative anemia on outcomes in patients undergoing elective cranial surgery","volume":"120","author":"Alan N","year":"2014","unstructured":"Alan N, Seicean A, Seicean S, Neuhauser D, Weil RJ: Impact of preoperative anemia on outcomes in patients undergoing elective cranial surgery. 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