The comparison and analysis of risk factors and outcomes of arterial ischemic stroke and hemorrhagic stroke in children / 临床儿科杂志

ABSTRACT

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.