Evidence map›Paper›PMID 40351190›Full record

ArticleStroke2025

Changing Management of Focal Cerebral Arteriopathy of Childhood From 2010 to 2022.

Heather J Fullerton, Nancy K Hills, Hui Chen, Nomazulu Dlamini, Nicholas V Stence, Max Wintermark, VIPS II Investigators

2 registry-linked trialsAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT04873583 phase3recruitingnot on this map

High Dose Steroids in Children With Stroke and Unilateral Focal Arteriopathy: A Multicentre Randomized Controlled Trial PASTA (Paediatric Arteriopathy Steroid Aspirin) Trial

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2021 to 2026Enrolled70ConditionsPaediatric StrokeArmsMethylprednisolone, Prednisolone
NCT06040255 phase4enrolling by invitationnot on this map

Focal Cerebral Arteriopathy Steroid Trial

TypeinterventionalSponsorUniversity of California, San FranciscoRan2023 to 2030Enrolled80ConditionsPediatric Stroke, Arteriopathy, Arterial Ischemic StrokeArmsmethylprednisolone, prednisolone, prednisone
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Heather J FullertonDepartments of Neurology (H.J.F., N.K.H.), University of California San Francisco.ORCID 0000-0002-4828-1687
Nancy K HillsDepartments of Neurology (H.J.F., N.K.H.), University of California San Francisco.ORCID 0000-0002-1041-8182
Hui ChenDepartment of Radiology, MD Anderson Cancer Center, Houston, TX (H.C., M.W.).ORCID 0000-0002-4479-0185
Nomazulu DlaminiDepartment of Paediatrics, Division of Neurology, Hospital for Sick Children, Toronto, Canada (N.D.).ORCID 0000-0001-5927-3132
Nicholas V StenceDepartment of Radiology, University of Colorado, Denver (N.V.S.).
Max WintermarkDepartment of Radiology, MD Anderson Cancer Center, Houston, TX (H.C., M.W.).ORCID 0000-0002-6726-3951
VIPS II Investigators

Funding

The Vascular effects of Infection in Pediatric Stroke (VIPS II) StudyR01NS104094 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FULLERTON, HEATHER J · 2017 to 2022
$3.5M
NINDS NIH HHS R01 NS104094
6 · The paper itself

Abstract

backgroundThe most common cause of arterial ischemic stroke in healthy children, focal cerebral arteriopathy (FCA), can progress rapidly over days with worsening brain injury. A 2017 retrospective Swiss study of corticosteroid treatment for FCA changed practice. To assess its impact, we compared the FCA cohorts from the 2 VIPS (Vascular Effects of Infection in Pediatric Stroke) prospective cohort studies.

methodsThe VIPS II study prospectively enrolled 205 children (29 days to 18 years) with arterial ischemic stroke at 22 centers, December 2016 to January 2022. The local team measured 12-month outcomes using the pediatric stroke outcome measure. A neuroradiologist and pediatric vascular neurologist independently reviewed all clinically obtained imaging and clinical data to classify the cause of arterial ischemic stroke. The neuroradiologist measured the FCA Severity Score on vascular imaging performed at any time poststroke. We compared the VIPS II FCA cohort to the previously published FCA cohort from VIPS I (2010-2014; 37 centers).

resultsOf 75 children with definite arteriopathy enrolled in VIPS II, 32 (43%) had FCA, compared with 41 of 127 (32%) of definite arteriopathy cases in VIPS I. The median age was 11.3 years (56% male) in VIPS I and 11.4 years (55%) in VIPS II. Treatment with intravenous corticosteroids increased from 2 of 41 (5%) of FCA patients in VIPS I to 18 of 32 (56%) in VIPS II. The VIPS II FCA cases were more severe at baseline (median FCA Severity Score 6 versus 4;

conclusionsTreatment of FCA with corticosteroids increased dramatically between the VIPS I and VIPS II studies. VIPS II cases were more severe at baseline, but we observed no significant difference in disease progression or neurological outcomes. Given the low level of evidence supporting corticosteroid therapy, pediatric stroke centers should enroll FCA patients into ongoing FCA corticosteroid treatment trials. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifiers: NCT04873583 and NCT06040255.

Indexed as

Adrenal Cortex HormonesCerebral Arterial DiseasesIschemic StrokeAdolescentChildChild, PreschoolClinical Trials as TopicCohort StudiesDisease ManagementFemaleHumansInfantInfant, NewbornMaleMulticenter Studies as TopicProspective StudiesAdrenal Cortex Hormonescerebrovascular disordersdisease progressionischemic strokeoutcome assessment, health carestroke

Identifiers

PMID40351190
PMCPMC12101933

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.