RESUMO
Objective:To explore the clinical charecteristics, imaging features, therapy and prognosis of stroke in children, and provide help for clinical treatment.Methods:The clinical data of 49 children with stroke were collectedand retrospectively analyzed in the Children′s Hospital of Soochow University from January 1, 2019 to December 31, 2019.Results:A mong the 49 children with stroke, 35 were male and 14 were female, aged 1-178 (65.69 ± 55.22) months; the specific etiologies were cerebrovascular malformation, craniocerebral trauma, tumor, vitamin K deficiencies, infectious diseases, rheumatic immune diseases, hemophilia and congenital heart disease. The first symptoms of stroke were disturbance of consciousness, hemiplegia, convulsions, vomiting and headache. The arterial ischemic stroke (18 cases) were mainly caused by craniocerebral trauma and cerebrovascular malformation. The hemorrhagic stroke (31 cases) were mainly caused by arteriovenous malformation, vitamin K deficiency and tumor. The surgical rate in the arterial stroke group was significantly lower than that in the hemorrhagic stroke group.Conclusions:Traumatic cerebral infarction and intracranial arteriovenous malformation are the main causes of arterial ischemic stroke and hemorrhagic stroke in children. Early diagnosis and treatment can significantly improve prognosis.
RESUMO
Objective:To investigate the prognosis of pediatric arterial ischemic stroke(PAIS).Methods:We retrospectively analyzed the clinical data of patients aging from 1 month to 18 years old who were diagnosed with PAIS at the Emergency Department of Beijing Children′s Hospital from July 2015 to April 2020.We used the modified Rankin scale(MRS)to evaluate patients.We analyzed their recovery of neurological function, mortality rates, and the recurrence of PAIS, while statistically calculating the risk factors leading to disability and death caused by PAIS.Results:A total of 101 children with PAIS were involved.During the follow-up period, 32.7%(33/101)had no obvious neurological sequelae(MRS 0), and 24.8%(25/101)had mild symptoms that did not affect the patients′daily life(MRS 1). The proportion of mild disability(MRS 2)and moderate to severe disability(MRS 3-5)were 13.9%(14/101)and 9.9%(10/101), respectively.Notably, 18.8%(19/101)of the patients died during the follow-up period, and PAIS-related fatality rate was 7.9%.Of the 49 patients with MRS score of 1-5, 89.8%(44/49)had dyskinesia, 16.3%(8/49)had language disorder, 10.2%(5/49)had epilepsy, 10.2%(5/49)had intellectual impairment, and 4.1%(2/49)had memory impairment.Four children relapsed during the follow-up period.Infantile onset, cardiogenic stroke, consciousness disorder and multiple angiopathy may be the risk factors of severe disability and death of PAIS.Conclusion:PAIS has a certain probability of mortality and disability.Infantile onset, complicated with consciousness disorder, cardiogenic stroke and multiple angiopathy are risk factors for poor prognosis.
RESUMO
A stroke is a rare entity in pediatrics patients; that implies a very important clinical challenge. It is produced by the interruption of flow at the vascular level, producing neurological focus. Causes of childhood stroke are varied and different from adults; constituting one of the 10 leading causes of childhood mortality. We present of previously healthy 6 years old male patient who was admitted for hemiparesis, who was studied with neuroimaging and laboratory; diagnosed of ischemic stroke
Assuntos
Humanos , Masculino , Criança , Isquemia Encefálica/terapia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia , AVC Isquêmico , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios X , Isquemia Encefálica/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Angiografia por Tomografia ComputadorizadaRESUMO
Stroke is among the top 10 causes of death and a leading cause of childhood disability. Pediatric arterial ischemic stroke (AIS) differs from adult AIS in several ways. There are many risk factors among which non-atherosclerotic arterial disease and heart disease are the most frequently identified risk factors of AIS in children. Clinical manifestations do vary with age. The clinical manifestations are extremely atypical in neonates and infants. The treatment and prognosis are obviously different from that of adults. This review will discuss important developments in childhood arterial ischemic stroke, focus on improved understanding of the risk factors,clinical manifestations,consequences and targets for intervention.
RESUMO
ObjectivesTo study the clinical characteristics, the risk factors and outcomes of arterial ischemic stroke (AIS) and hemorrhagic stroke (HS) in children.MethodsThe clinical data from 142 children with AIS or HS were retrospectively re-viewed and compared from Nov. 2010 to May 2014.ResultsIn these children, 92 cases (64.8%) was diagnosed of AIS, amont whom there were 60 males and 32 females and the onset age of stroke was 4.6±3.6 years (1 months to 16 years old), and 50 cases (35.2%) was diagnosed of HS, among whom there were 34 males and 16 females and the onset age of stroke was 2.6±3.7 years (1 months to 13 years old). The difference in age between two groups was statistically signiifcant (P=0.007). The most common presentation of AIS were focal neurological dysfunction including paralysis (73 cases, 79.3%), central facial palsy (30 cases, 32.6%) and speech impairment (19 cases, 20.7%). The most common presentation of HS were diffuse neurological dysfunction including dizziness (29 cases, 58.0%), nausea/vomiting (22 cases, 44.0%) and headache (14 cases, 28.0%). The major risk factors of AIS were arteriopathy (49 cases, 53.3%), infection (47 cases, 51.1%) and minor head injury (16 cases, 17.4%). The major risk factors of HS were vitamin K deifciency (22 cases, 44.0%), intracranial vascular anomalies (8 cases, 16.0%) and haematological disorders (6 cases, 12.0%). Five cases (6.4%) were died, 48 cases (61.5%) became disabled and 9 cases (11.5%) were relapsed in children with AIS while 15 cases (34.1%) were died, 19 cases (43.2%) became disabled in children with HS. The mortality was signiifcantly higher in children with HS than that in children with AIS (P<0.01).ConclusionsIn childhood stroke, HS occurs more frequently than is commonly appreciated and it has a poorer prognosis than AIS.
RESUMO
A wide range of underlying systemic factors have been reported in the setting of childhood stroke. Emerging research demonstrates that non-atherosclerotic intracerebral arteriopathies are the main risk factors. Minor infections may play a role in arteriopathies. Nonspecific presentation and doctor' s lacking awareness of pediatric stroke both contribute to initial misdiagnoses that result in delays in management. Acute management of children with stroke is primarily supportive including control of fever, blood pressure normalization to accepted age ranges, normalization of glucose, and maintenance of normal oxygenation, but there is no golden standard therapy at home and abroad. For secondary stroke prevention, the majority of children are treated with adult stroke therapeutic schedule. The prognosis of childhood stroke is not satisfactory. Many of these children are left with permanent neurologic deficits including injury of motor, sensory and cognitive defect and epilepsy.
RESUMO
0.05).The abrupt onset of the inflammatory arteriopathy group was 10 cases(31.2%),the abrupt onset of the noninflammatory arteriopathy group was 38 cases(58.5%),there was significant difference for the mode of onset between the 2 groups(?2=6.352 P
RESUMO
BACKGROUND: In the western hemisphere, resistance to activated protein C (APCR) is the most common risk factor for venous thromboembolic disease. A one-point mutation in the coagulation factor V that renders it APCR is found in more than 90% of patients with APC-resistant venous thrombosis. In Hispanic and Caucasian patients with arterial ischemic stroke, the prevalence of APC-R is approximately 10%. To determine the prevalence of APC resistance and its causative factor V mutation (Arg 506 Gln) in Koreans, we screened a group of Korean ischemic stroke patients. METHODS: We evaluated 60 Korean patients with arterial ischemic stroke diagnosed by either magnetic resonance neu-roimaging, conventional angiogram, or both, after 2 weeks of symptom onset. The mean age of the subjects was 59.2 years (13-82 years). APC resistance was expressed as a ratio of the activated partial thromboplastin time (aPTT) with and without adding APC to the subject's plasma. The presence of the factor V Leiden (Arg 506 Gln) mutation was determined by a direct polymerase chain reaction-based assay on peripheral blood leukocytes. RESULTS: Only one patient (n=1/60, 1.6%) had APC resistance and none were found to have the factor V Leiden (Arg 506 Gln) mutation. CONCLUSIONS: APCR and the factor V Leiden mutation do not seem to be a significant genetic risk factor for arterial ischemic stroke in Koreans.