ABSTRACT
OBJECTIVE: To evaluate the contribution of antiphospholipid antibodies (aPL) and thrombomodulin (Thm) in the pathogenesis of stroke and migraine in children. MATERIALS AND METHODS: Ninety children were included in the study: 30 children (4-15 years) after an ischemic stroke of an unknown etiology; 30 migrainous patients (8-15 years), who were hospitalized in the Department of Developmental Neurology, Medical University of Gdansk, Poland, and 30 healthy children of the same age. RESULTS: The statistical analysis showed an increase in the values of anticardiolipin antibodies (aCL), anti beta2-glycoprotein 1 (beta2-GP1) and Thm in children with stroke and migraine than in the control group. The resultant values were higher, but stayed at standard. CONCLUSION: The possible role of prothrombotic factors in individual cases of pediatric stroke and migraine cannot be excluded.
Subject(s)
Antibodies, Antiphospholipid/blood , Brain Ischemia/etiology , Intracranial Thrombosis/complications , Migraine Disorders/etiology , Stroke/etiology , Thrombomodulin/blood , Adolescent , Antibodies, Anticardiolipin/analysis , Antibodies, Anticardiolipin/blood , Antibodies, Antiphospholipid/analysis , Blood Coagulation/physiology , Brain Ischemia/blood , Brain Ischemia/physiopathology , Causality , Cerebral Arteries/metabolism , Cerebral Arteries/physiopathology , Child , Child, Preschool , Endothelium, Vascular/metabolism , Endothelium, Vascular/physiopathology , Female , Glycoproteins/immunology , Humans , Intracranial Thrombosis/blood , Intracranial Thrombosis/diagnosis , Male , Migraine Disorders/blood , Migraine Disorders/physiopathology , Predictive Value of Tests , Stroke/blood , Stroke/physiopathology , Thrombomodulin/analysis , beta 2-Glycoprotein IABSTRACT
The most frequent type of head injury in children is closed head trauma with brain concussion or contusion, and headache is the dominant complaint of early and late postinjury period. Because of scant number of studies on the problem of occurrence, characteristics and persistence of posttraumatic headache this study was undertaken in a group of 100 children (29 girls and 71 boys), aged 3-14 years old, 90 after brain concussion and 10 after contusion. Children with a history of injuries, central nervous system infections, with headaches before injury and chronic diseases were excluded. In 9 cases linear skull fracture was present after injury. The material was examined within one week after trauma, and then after 3, 6, and 12 months. After 3 months EEG was performed and repeated after 6 and 12 months in children with persistent headache or those without headache but with abnormal EEG results in the first examination. According to the additional diagnostic examinations, I excluded other causes of headache, besides head injury. In my observation 83% of children had headache after brain concussion and contusion. The majority--56%--had acute posttraumatic headache, but 27% of children complained of chronic headache, mainly tension type headache. Only 3% had migraine. In 21% of all group of 100 children, I noticed the headache persisting during the whole year of my observation. The important risk factor for the occurrence of posttraumatic headache were the age of child at the moment injury and the period of unconsciousness. The electroencephalographic recording still remains the important additional examination of posttraumatic consequences.
