ABSTRACT
BACKGROUND AND AIM: Intracerebral hemorrhage (ICH) accounts for about half of all childhood strokes and is a notable contributor to childhood morbidity and mortality. The aim of this study is to describe the characteristics of cases of ICH that were hospitalized in a PICU during a 10-year period. METHOD(S): Patients' files between 2011-2021 were studied retrospectively. Cases with non-traumatic intracerebral hemorrhage were included in the study. RESULT(S): 18 patients were examined (38.8% male) with a median age of 7 years (3 months-14 years). 83% were of Greek origin and mean duration was 6.3 days. Half of our patients were hospitalized between 2020-2021 (see image 1.). 33.3% had relevant comorbidities such as arteriovenous malformation (AVM), hemangiomas and neurofibromatosis type. Presenting symptoms were headache (55.5%), nausea and emesis (66.6%), seizures (27.7%), altered level of consciousness (65.5%), paresis (22%). Glasgow Coma Scale at admission was 13-15 in 66.6%, 9-12 in 22.2% and < 9 in 5%. Diagnosis was made using CT (88,9%) and MRI scans (11.1%). 61% needed surgery while 72% underwent digital subtraction angiography (DSA) and 38.4% of them were embolized. Vascular malformations were the main causes: AVM (38.8%), aneurysm (5%), pseudoaneurysm (5%), hemangioma (5%) but 46,2% remained unidentified. No patient died but 33.3% showed neurological deficits after discharge CONCLUSION(S): Intracerebral Hemorrhage in children is an urgent situation that needs collaboration between intensivists and neurosurgeons. The increase in frequency during COVID-19 pandemic is remarkable and needs further studying to determine a possible causative relation.
ABSTRACT
BACKGROUND AND AIM: The clinical manifestations of the pediatric population with Sars-Cov-2 infection vary and seem to be milder than adults. Although, seldom, children can manifest life-threatening respiratory disease. This study aims to present the experience of a single-center Pediatric Intensive Care Unit (PICU). METHOD(S): A retrospective review was performed between October 2020 and January 2022 in children, hospitalized with SARS-CoV-2 infection, in a referral PICU. The medical records of the patients were reviewed in terms of demographic characteristics, clinical and laboratory data. All patients, from birthday day to 16 years old, admitted with confirmed SARS-CoV-2 infection, with respiratory involvement, were included. RESULT(S): The data of 16 patients were analyzed, 9 (56%) were males, with median age 6 years. Comorbidities were ascertained in 5 patients, concerned mainly obesity (n=3), and neurological disorders (n=2). The mean duration of the hospitalization was 6,1 days. Twelve patients had an X-ray chest consistent with Covid-19. Six patients had cardiovascular involvement. Only three patients were supported with mechanical ventilation, two had co-morbidities. A mild prevalence of leukopenia was observed (n=8). Fifteen patients received corticosteroids, 12 Remdesivir and 6 immunomodulatory treatment. All patients received antibiotics. Two patients died, one was a newborn, without past medical history and the other had co-morbidities. CONCLUSION(S): This study highlights that there is a low but not negligible risk of a life-threatening disease which can be combined with the age and the co-morbidities of the patient. Additional studies are needed to evaluate clinical and laboratory findings so to analyze possible correlations.