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Diagnosis of Pediatric Stroke in Resource Limited Settings.
Tan, Marilyn A; Layug, Elbert John V; Singh, Bhanu Pratap; Parakh, Manish.
  • Tan MA; Division of Pediatric Neurology, Departments of Pediatrics and Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines. Electronic address: matan6@up.edu.ph.
  • Layug EJV; Division of Pediatric Neurology, Departments of Pediatrics and Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines.
  • Singh BP; Dr SN Medical College, Jodhpur, Rajasthan, India.
  • Parakh M; Dr SN Medical College, Jodhpur, Rajasthan, India.
Semin Pediatr Neurol ; 44: 100997, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2283454
ABSTRACT
Global awareness of stroke as a significant cause of neurologic sequelae and death in children has increased over the years as more data in this field becomes available. However, most published literature on pediatric stroke have limited geographic representation. Data on childhood stroke from developing countries remains limited. Thus, this paper reviewed geographic/ethnic differences in pediatric stroke risk factors highlighting those reported in low- and middle-income countries, and proposes a childhood arterial ischemic stroke diagnostic algorithm for resource limited settings. Stroke risk factors include cardiac disorders, infectious diseases, cerebral arteriopathies, hematologic disorders, inflammatory diseases, thrombophilia and genetic conditions. Infection of the central nervous system particularly tuberculous meningitis, is a leading cause of pediatric arterial ischemic stroke in developing countries. Stroke should be considered in children with acute focal neurologic deficit especially in the presence of aforementioned risk factors. Cranial magnetic resonance imaging with angiography is the neuroimaging modality of choice but if unavailable, cranial computed tomography with angiography may be performed as an alternative. If both are not available, transcranial doppler together with neurologic exam may be used to screen children for arterial ischemic stroke. Etiological diagnosis follows with the aid of appropriate laboratory tests that are available in each level of care. International collaborative research on stroke risk factors that are prevalent in low and middle income countries will provide information for drafting of stroke care guidelines that are universal yet inclusive taking into consideration regional differences in available resources with the goal of reducing global stroke burden.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Ischemic Stroke Type of study: Diagnostic study / Etiology study / Prognostic study Topics: Long Covid Limits: Child / Humans Language: English Journal: Semin Pediatr Neurol Journal subject: Neurology / Pediatrics Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Ischemic Stroke Type of study: Diagnostic study / Etiology study / Prognostic study Topics: Long Covid Limits: Child / Humans Language: English Journal: Semin Pediatr Neurol Journal subject: Neurology / Pediatrics Year: 2022 Document Type: Article