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<meta name="DC.Title" content="Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5376" />
<meta name="DC.Date" content="2017-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Childhood arteriopathies are rare but heterogenous, and difficult to diagnose and classify, especially by nonexperts. We quantified clinical and imaging characteristics associated with childhood arteriopathy subtypes to facilitate their diagnosis and classification in research and clinical settings.

MATERIALS AND METHODS: The Vascular Effects of Infection in Pediatric Stroke (VIPS) study prospectively enrolled 355 children with arterial ischemic stroke (2010–2014). A central team of experts reviewed all data to diagnose childhood arteriopathy and classify subtypes, including arterial dissection and focal cerebral arteriopathy–inflammatory type, which includes transient cerebral arteriopathy, Moyamoya disease, and diffuse/multifocal vasculitis. Only children whose stroke etiology could be conclusively diagnosed were included in these analyses. We constructed logistic regression models to identify characteristics associated with each arteriopathy subtype.

RESULTS: Among 127 children with definite arteriopathy, the arteriopathy subtype could not be classified in 18 (14%). Moyamoya disease ( n = 34) occurred mostly in children younger than 8 years of age; focal cerebral arteriopathy–inflammatory type ( n = 25), in children 8–15 years of age; and dissection ( n = 26), at all ages. Vertigo at stroke presentation was common in dissection. Dissection affected the cervical arteries, while Moyamoya disease involved the supraclinoid internal carotid arteries. A banded appearance of the M1 segment of the middle cerebral artery was pathognomonic of focal cerebral arteriopathy–inflammatory type but was present in &lt;25% of patients with focal cerebral arteriopathy–inflammatory type; a small lenticulostriate distribution infarct was a more common predictor of focal cerebral arteriopathy–inflammatory type, present in 76%. It remained difficult to distinguish focal cerebral arteriopathy–inflammatory type from intracranial dissection of the anterior circulation. We observed only secondary forms of diffuse/multifocal vasculitis, mostly due to meningitis.

CONCLUSIONS: Childhood arteriopathy subtypes have some typical features that aid diagnosis. Better imaging methods, including vessel wall imaging, are needed for improved classification of focal cerebral arteriopathy of childhood.

FCA
:   focal cerebral arteriopathy of childhood
FCA-d
:   focal cerebral arteriopathy–dissection type
FCA-i
:   focal cerebral arteriopathy–inflammatory type
TCA
:   transient cerebral arteriopathy
VIPS
:   Vascular Effects of Infection in Pediatric Stroke" />
<meta name="DC.Contributor" content="M. Wintermark" />
<meta name="DC.Contributor" content="N.K. Hills" />
<meta name="DC.Contributor" content="G.A. DeVeber" />
<meta name="DC.Contributor" content="A.J. Barkovich" />
<meta name="DC.Contributor" content="T.J. Bernard" />
<meta name="DC.Contributor" content="N.R. Friedman" />
<meta name="DC.Contributor" content="M.T. Mackay" />
<meta name="DC.Contributor" content="A. Kirton" />
<meta name="DC.Contributor" content="G. Zhu" />
<meta name="DC.Contributor" content="C. Leiva-Salinas" />
<meta name="DC.Contributor" content="Q. Hou" />
<meta name="DC.Contributor" content="H.J. Fullerton" />
<meta name="DC.Contributor" content="the VIPS Investigators" />
<meta name="article:published_time" content="2017-11-01" />
<meta name="article:section" content="Pediatrics" />
<meta name="citation_title" content="Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Childhood arteriopathies are rare but heterogenous, and difficult to diagnose and classify, especially by nonexperts. We quantified clinical and imaging characteristics associated with childhood arteriopathy subtypes to facilitate their diagnosis and classification in research and clinical settings.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The Vascular Effects of Infection in Pediatric Stroke (VIPS) study prospectively enrolled 355 children with arterial ischemic stroke (2010–2014). A central team of experts reviewed all data to diagnose childhood arteriopathy and classify subtypes, including arterial dissection and focal cerebral arteriopathy–inflammatory type, which includes transient cerebral arteriopathy, Moyamoya disease, and diffuse/multifocal vasculitis. Only children whose stroke etiology could be conclusively diagnosed were included in these analyses. We constructed logistic regression models to identify characteristics associated with each arteriopathy subtype.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Among 127 children with definite arteriopathy, the arteriopathy subtype could not be classified in 18 (14%). Moyamoya disease (&lt;i&gt;n&lt;/i&gt; = 34) occurred mostly in children younger than 8 years of age; focal cerebral arteriopathy–inflammatory type (&lt;i&gt;n&lt;/i&gt; = 25), in children 8–15 years of age; and dissection (&lt;i&gt;n&lt;/i&gt; = 26), at all ages. Vertigo at stroke presentation was common in dissection. Dissection affected the cervical arteries, while Moyamoya disease involved the supraclinoid internal carotid arteries. A banded appearance of the M1 segment of the middle cerebral artery was pathognomonic of focal cerebral arteriopathy–inflammatory type but was present in &amp;lt;25% of patients with focal cerebral arteriopathy–inflammatory type; a small lenticulostriate distribution infarct was a more common predictor of focal cerebral arteriopathy–inflammatory type, present in 76%. It remained difficult to distinguish focal cerebral arteriopathy–inflammatory type from intracranial dissection of the anterior circulation. We observed only secondary forms of diffuse/multifocal vasculitis, mostly due to meningitis.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Childhood arteriopathy subtypes have some typical features that aid diagnosis. Better imaging methods, including vessel wall imaging, are needed for improved classification of focal cerebral arteriopathy of childhood.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2017/11/01" />
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<meta name="citation_volume" content="38" />
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<meta name="citation_author" content="M. Wintermark" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology (M.W.), Neuroradiology Division, Stanford University, Stanford, California" />
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<meta name="citation_author" content="N.K. Hills" />
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<meta name="twitter:title" content="Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Childhood arteriopathies are rare but heterogenous, and difficult to diagnose and classify, especially by nonexperts. We quantified clinical and imaging characteristics associated with childhood arteriopathy subtypes to facilitate their diagnosis and classification in research and clinical settings.

MATERIALS AND METHODS: The Vascular Effects of Infection in Pediatric Stroke (VIPS) study prospectively enrolled 355 children with arterial ischemic stroke (2010–2014). A central team of experts reviewed all data to diagnose childhood arteriopathy and classify subtypes, including arterial dissection and focal cerebral arteriopathy–inflammatory type, which includes transient cerebral arteriopathy, Moyamoya disease, and diffuse/multifocal vasculitis. Only children whose stroke etiology could be conclusively diagnosed were included in these analyses. We constructed logistic regression models to identify characteristics associated with each arteriopathy subtype.

RESULTS: Among 127 children with definite arteriopathy, the arteriopathy subtype could not be classified in 18 (14%). Moyamoya disease ( n = 34) occurred mostly in children younger than 8 years of age; focal cerebral arteriopathy–inflammatory type ( n = 25), in children 8–15 years of age; and dissection ( n = 26), at all ages. Vertigo at stroke presentation was common in dissection. Dissection affected the cervical arteries, while Moyamoya disease involved the supraclinoid internal carotid arteries. A banded appearance of the M1 segment of the middle cerebral artery was pathognomonic of focal cerebral arteriopathy–inflammatory type but was present in &lt;25% of patients with focal cerebral arteriopathy–inflammatory type; a small lenticulostriate distribution infarct was a more common predictor of focal cerebral arteriopathy–inflammatory type, present in 76%. It remained difficult to distinguish focal cerebral arteriopathy–inflammatory type from intracranial dissection of the anterior circulation. We observed only secondary forms of diffuse/multifocal vasculitis, mostly due to meningitis.

CONCLUSIONS: Childhood arteriopathy subtypes have some typical features that aid diagnosis. Better imaging methods, including vessel wall imaging, are needed for improved classification of focal cerebral arteriopathy of childhood.

FCA
:   focal cerebral arteriopathy of childhood
FCA-d
:   focal cerebral arteriopathy–dissection type
FCA-i
:   focal cerebral arteriopathy–inflammatory type
TCA
:   transient cerebral arteriopathy
VIPS
:   Vascular Effects of Infection in Pediatric Stroke" />
<meta name="og-title" property="og:title" content="Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/11/2172" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Childhood arteriopathies are rare but heterogenous, and difficult to diagnose and classify, especially by nonexperts. We quantified clinical and imaging characteristics associated with childhood arteriopathy subtypes to facilitate their diagnosis and classification in research and clinical settings.

MATERIALS AND METHODS: The Vascular Effects of Infection in Pediatric Stroke (VIPS) study prospectively enrolled 355 children with arterial ischemic stroke (2010–2014). A central team of experts reviewed all data to diagnose childhood arteriopathy and classify subtypes, including arterial dissection and focal cerebral arteriopathy–inflammatory type, which includes transient cerebral arteriopathy, Moyamoya disease, and diffuse/multifocal vasculitis. Only children whose stroke etiology could be conclusively diagnosed were included in these analyses. We constructed logistic regression models to identify characteristics associated with each arteriopathy subtype.

RESULTS: Among 127 children with definite arteriopathy, the arteriopathy subtype could not be classified in 18 (14%). Moyamoya disease ( n = 34) occurred mostly in children younger than 8 years of age; focal cerebral arteriopathy–inflammatory type ( n = 25), in children 8–15 years of age; and dissection ( n = 26), at all ages. Vertigo at stroke presentation was common in dissection. Dissection affected the cervical arteries, while Moyamoya disease involved the supraclinoid internal carotid arteries. A banded appearance of the M1 segment of the middle cerebral artery was pathognomonic of focal cerebral arteriopathy–inflammatory type but was present in &lt;25% of patients with focal cerebral arteriopathy–inflammatory type; a small lenticulostriate distribution infarct was a more common predictor of focal cerebral arteriopathy–inflammatory type, present in 76%. It remained difficult to distinguish focal cerebral arteriopathy–inflammatory type from intracranial dissection of the anterior circulation. We observed only secondary forms of diffuse/multifocal vasculitis, mostly due to meningitis.

CONCLUSIONS: Childhood arteriopathy subtypes have some typical features that aid diagnosis. Better imaging methods, including vessel wall imaging, are needed for improved classification of focal cerebral arteriopathy of childhood.

FCA
:   focal cerebral arteriopathy of childhood
FCA-d
:   focal cerebral arteriopathy–dissection type
FCA-i
:   focal cerebral arteriopathy–inflammatory type
TCA
:   transient cerebral arteriopathy
VIPS
:   Vascular Effects of Infection in Pediatric Stroke" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node56836--5" data-node-nid="56836" id="top-node-56836--61746850288" data-pisa="ajnr;38/11/2172" data-pisa-master="ajnr;ajnr.A5376" data-apath="/ajnr/38/11/2172.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Pediatrics</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M. Wintermark</span>, <span class="highwire-citation-author" data-delta="1">N.K. Hills</span>, <span class="highwire-citation-author" data-delta="2">G.A. DeVeber</span>, <span class="highwire-citation-author" data-delta="3">A.J. Barkovich</span>, <span class="highwire-citation-author" data-delta="4">T.J. Bernard</span>, <span class="highwire-citation-author" data-delta="5">N.R. Friedman</span>, <span class="highwire-citation-author" data-delta="6">M.T. Mackay</span>, <span class="highwire-citation-author" data-delta="7">A. Kirton</span>, <span class="highwire-citation-author" data-delta="8">G. Zhu</span>, <span class="highwire-citation-author" data-delta="9">C. Leiva-Salinas</span>, <span class="highwire-citation-author" data-delta="10">Q. Hou</span>, <span class="highwire-citation-author" data-delta="11">H.J. Fullerton</span> and <span class="highwire-citation-author" data-delta="12"><span class="nlm-collab" data-hwp-id="collab-1">the VIPS Investigators</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2172-2179; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5376 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-56836--61746850288" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M. Wintermark </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (M.W.), Neuroradiology Division, Stanford University, Stanford, California</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BWintermark%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wintermark%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BWintermark%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6726-3951" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Wintermark</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">N.K. Hills </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Neurology (N.K.H., H.J.F.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Biostatistics and Epidemiology (N.K.H.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.K.%2BHills%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hills%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.K.%2BHills%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1041-8182" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N.K. Hills</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">G.A. DeVeber </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Neurology (G.A.D.), Hospital for Sick Children, Toronto, Ontario, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.A.%2BDeVeber%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=DeVeber%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.A.%2BDeVeber%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9584-0576" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G.A. DeVeber</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A.J. Barkovich </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Radiology (A.J.B., H.J.F.)</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Pediatrics (A.J.B.),University of California, San Francisco, San Francisco, California</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.J.%2BBarkovich%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Barkovich%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.J.%2BBarkovich%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4291-7346" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.J. Barkovich</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">T.J. Bernard </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Pediatrics (T.J.B.), University of Colorado, Denver, Colorado</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.J.%2BBernard%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bernard%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.J.%2BBernard%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9767-5156" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T.J. Bernard</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">N.R. Friedman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>h</span>Center for Pediatric Neurology (N.R.F.), Neurological Institute, Cleveland Clinic, Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.R.%2BFriedman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Friedman%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.R.%2BFriedman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-7349-7981" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N.R. Friedman</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">M.T. Mackay </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>i</span>Children's Stroke Program (M.T.M.), Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.T.%2BMackay%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mackay%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.T.%2BMackay%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3787-1112" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.T. Mackay</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">A. Kirton </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>j</span>Departments of Pediatrics and Clinical Neurosciences (A.K.), Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BKirton%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kirton%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BKirton%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5209-3374" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. 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Zhu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>k</span>Department of Neurology (G.Z.), Military General Hospital of Beijing PLA, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BZhu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhu%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BZhu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5519-3135" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Zhu</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">C. Leiva-Salinas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>l</span>Department of Radiology (C.L.-S.), University of Virginia, Charlottesville, Virginia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BLeiva-Salinas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Leiva-Salinas%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BLeiva-Salinas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6653-0774" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Leiva-Salinas</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">Q. Hou </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>m</span>Department of Neurology (Q.H.), Guangdong No.2 Provincial People's Hospital, Guangzhou, China.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Q.%2BHou%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hou%20Q&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AQ.%2BHou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0678-1840" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Q. 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      <div class="highwire-cite-title">Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Wintermark</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">N.K.</span> <span class="nlm-surname">Hills</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">G.A.</span> <span class="nlm-surname">DeVeber</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Barkovich</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">T.J.</span> <span class="nlm-surname">Bernard</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">N.R.</span> <span class="nlm-surname">Friedman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">M.T.</span> <span class="nlm-surname">Mackay</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kirton</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Zhu</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Leiva-Salinas</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Q.</span> <span class="nlm-surname">Hou</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">H.J.</span> <span class="nlm-surname">Fullerton</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-collab" data-hwp-id="collab-1">the VIPS Investigators</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2172-2179; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5376 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Wintermark</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">N.K.</span> <span class="nlm-surname">Hills</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">G.A.</span> <span class="nlm-surname">DeVeber</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Barkovich</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">T.J.</span> <span class="nlm-surname">Bernard</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">N.R.</span> <span class="nlm-surname">Friedman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">M.T.</span> <span class="nlm-surname">Mackay</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kirton</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Zhu</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Leiva-Salinas</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Q.</span> <span class="nlm-surname">Hou</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">H.J.</span> <span class="nlm-surname">Fullerton</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-collab" data-hwp-id="collab-1">the VIPS Investigators</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2172-2179; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5376 </span></div>
  
  
  
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