Paediatric Arteriopathy Steroid Aspirin Project

Inclusion Criteria:

-- Aged 6 months to <15 years

• AIS ≤ 48 hours
• Newly acquired focal neurological deficit with confirmation by magnetic resonanceimaging (MRI) of ischaemic lesion in an arterial territory corresponding with theclinical features (definition of Arterial ischemic stroke).
• Magnetic resonance arteriography showing unilateral proximal stenosis orirregularities of the corresponding carotid trifurcation (i.e. terminal carotidand/or M1-M2 and/or A1 segments) or of the posterior circulation (P1-P2segments).
• No evidence of an underlying systemic disorder (e.g. lupus erythematodes)explaining the features.
• Informed and signed consent of parents or legal guardians.
• French Social Security (Sécurité sociale; i.e. national health coverage) affiliation

Exclusion Criteria:

• Children with secondary central nervous system angiitis due to infections (meningitis,endocarditis, borreliosis), rheumatic or other systemic inflammatory diseases (e.g.lupus erythematodes). These children are already under immune suppression or needother co-medications regarding their underlying disease.
• Children with known syndromal and/or genetic vasculopathies such as phaces syndrome,Neurofibromatosis type 1, trisomy 21.
• Children with moyamoya or sickle cell disease.
• Children with a progressive large to medium vessel childhood primary angiitis of thecentral nervous system with two out of the following three criteria : Children withprogressive neurocognitive dysfunction; Children with bilateral lesions/vesselinvolvement; Children with distal arterial stenosis (beyond the M2, A1 or P2 segment).
• Children already on steroid treatment at disease onset or with a contraindication toreceive steroid treatment (e.g. congenital or acquired immunodeficiency).
• Children with delayed diagnosis ≥3 days as treatment start is not allowed to be more ≥5 day-delayed.
• Contraindications to steroids (see also summary of product characteristics in chapter 1.1) and notably: Not-manageable infectious, hydro-electrolytic or metabolic (e.g.diabetes mellitus) disorders, or elevated blood pressure, Serious behavioraldisorders, Current vaccination with live or attenuated live strains,Allergy/sensibility to any ingredient, Association with some medications such asantiarrhythmic drugs.