Evidence map›Paper›PMID 27006453›Full record

ArticleStroke2016

Arterial Tortuosity: An Imaging Biomarker of Childhood Stroke Pathogenesis?

Felix Wei, Karl T Diedrich, Heather J Fullerton, Gabrielle deVeber, Max Wintermark, Jacquie Hodge, Adam Kirton, Vascular Effects of Infection in Pediatric Stroke (VIPS) Investigators

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
3.6field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 29 citations in OpenAlex.

  1. Article
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  3. Cerebrovascular morphology: Insights into normal variations, aging effects and disease implications.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2025
    Review
  4. Review
  5. Article
  6. Article
  7. Review
  8. Novel imaging markers for altered cerebrovascular morphology in aging, stroke, and Alzheimer's disease.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2022
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. CX3CR1-CCR2-dependent monocyte-microglial signaling modulates neurovascular leakage and acute injury in a mouse model of childhood stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2019
    Article
  14. Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 20 institutions in 10 countries.

Felix WeiFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M).
Karl T DiedrichFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M).
Heather J FullertonFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M).
Gabrielle deVeberFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M).
Max WintermarkFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M).
Jacquie HodgeFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M).
Adam KirtonFrom the Calgary Pediatric Stroke Program, Section of Neurology, Department of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada (F.W., J.H., A.K.); Mebio, Inc, Cambridge, MA (K.T.D.); Departments of Neurology and Pediatrics, University of California, San Francisco (H.J.F.); Department of Neurology, Hospital for Sick Children, Toronto, ON, Canada (G.d.V.); and Division of Neuroradiology, Department of Radiology, University of Virginia, Charlottesville (W.M). adam.kirton@albertahealthservices.ca.
Vascular Effects of Infection in Pediatric Stroke (VIPS) Investigators
ProterixBio (United States) · USUniversity of California, San Francisco · USUniversity of Calgary · CAAkron Children's Hospital · USAlberta Children's Hospital · CABoston Children's Hospital · USBritish Columbia Children's Hospital · CAChildren's Hospital Colorado · USChildren's Hospital of Eastern Ontario · CAChildren's Hospital of Philadelphia · USChildren's Hospital of Winnipeg · CAChildren's National · USChinese PLA General Hospital · CNCleveland Clinic · USColumbia University Irving Medical Center · USEvelina London Children's Healthcare · GBHôpital Robert-Debré · FRHospital for Sick Children · CAInstitute of Public Health of Serbia · RSMaimonides Medical Center · US

Funding

Research Project: Sensory and Multisensory Contributions to AutismU54HD083211 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DYKENS, ELISABETH MAY · 2015 to 2019
$7.1M
VIPS: Vascular Effects of Infection in Pediatric StrokeR01NS062820 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DEVEBER, GABRIELLE ALINE, FULLERTON, HEATHER J · 2009 to 2013
$6.6M
The Role of Infection in Childhood StrokeK02NS053883 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FULLERTON, HEATHER J · 2006 to 2010
$831k
NICHD NIH HHS U54 HD083211NINDS NIH HHS K02 NS053883NINDS NIH HHS R01 NS062820
6 · The paper itself

Abstract

background and purposeArteriopathy is the leading cause of childhood arterial ischemic stroke. Mechanisms are poorly understood but may include inherent abnormalities of arterial structure. Extracranial dissection is associated with connective tissue disorders in adult stroke. Focal cerebral arteriopathy is a common syndrome where pathophysiology is unknown but may include intracranial dissection or transient cerebral arteriopathy. We aimed to quantify cerebral arterial tortuosity in childhood arterial ischemic stroke, hypothesizing increased tortuosity in dissection.

methodsChildren (1 month to 18 years) with arterial ischemic stroke were recruited within the Vascular Effects of Infection in Pediatric Stroke (VIPS) study with controls from the Calgary Pediatric Stroke Program. Objective, multi-investigator review defined diagnostic categories. A validated imaging software method calculated the mean arterial tortuosity of the major cerebral arteries using 3-dimensional time-of-flight magnetic resonance angiographic source images. Tortuosity of unaffected vessels was compared between children with dissection, transient cerebral arteriopathy, meningitis, moyamoya, cardioembolic strokes, and controls (ANOVA and post hoc Tukey). Trauma-related versus spontaneous dissection was compared (Student t test).

resultsOne hundred fifteen children were studied (median, 6.8 years; 43% women). Age and sex were similar across groups. Tortuosity means and variances were consistent with validation studies. Tortuosity in controls (1.346±0.074; n=15) was comparable with moyamoya (1.324±0.038; n=15; P=0.998), meningitis (1.348±0.052; n=11; P=0.989), and cardioembolic (1.379±0.056; n=27; P=0.190) cases. Tortuosity was higher in both extracranial dissection (1.404±0.084; n=22; P=0.021) and transient cerebral arteriopathy (1.390±0.040; n=27; P=0.001) children. Tortuosity was not different between traumatic versus spontaneous dissections (P=0.70).

conclusionsIn children with dissection and transient cerebral arteriopathy, cerebral arteries demonstrate increased tortuosity. Quantified arterial tortuosity may represent a clinically relevant imaging biomarker of vascular biology in pediatric stroke.

Indexed as

AdolescentArteriesBiomarkersBrain IschemiaCerebral Arterial DiseasesChildChild, PreschoolComorbidityFemaleHumansInfantJoint InstabilityMaleMeningitisMoyamoya DiseaseMyocardial InfarctionBiomarkersarterial tortuositychilddissectionmagnetic resonance angiographypediatric strokestroke

Identifiers

PMID27006453
PMCPMC4846544
OpenAlexW2305585655

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.