[Clinical and neuroimaging signs of cardioembolic stroke laboratory in children]. / Klinicheskie i neirovizualizatsionnye priznaki kardioémbolicheskogo insul'ta u detei.

AIM: To study clinical and neuroimaging signs of cardioembolic stroke (CES) in children. MATERIAL AND METHODS: Ten children (mean age 3.5±3.5 years) were examined. Eight children met the diagnostic criteria of CES CASCADE, two children were diagnosed with CES based on the complex of symptoms. A comparison group consisted of 90 children with other subtypes of ischemic stroke (IS). The diagnosis was confirmed by MRI and magnetic-resonance angiography; symptom severity was assessed with PedNIHSS and PSOM. RESULTS AND CONCLUSION: The PedNIHSS score in the acute stage of CES was higher (18.4±9.34) compared to patients with other subtypes of IS (12.6±6.2; p=0.0065). Six patients had large cerebral infarctions with the involvement of basal ganglia, internal capsule, white matter and cerebral cortex. In two patients, the infarction affected the cerebral cortex and underlying white matter, in one patient it affected the cortex from one side and the basal ganglia from the other. A damage of the cortex was noted in one patient. The frequency of recurrent CES was 30%, of fatal cases 20%. Recurrent IS and severe residual neurological deficit were more frequent in CES. CONCLUSION: Early disease onset, acute development and progression of neurological deficit up to the maximal level in the first 5 min, marked severity of the acute stage (PedNIHSS score >15), early onset of neurological function recovery, marked residual neurological deficit (PSOM score >2) are the additional signs of CES.

[Clinical and neuroimaging signs of cardioembolic stroke in children]. / Klinicheskie i neirovizualizatsionnye priznaki kardioémbolicheskogo insul'ta u detei.

AIM: To study clinical and neuroimaging signs of cardioembolic stroke (CES) in children. MATERIAL AND METHODS: A group of 100 patients with arterial ischemic stroke (AIS), aged from 1 month to 15 years, was stratified into the main group (10 patients with CES) and the comparison group (90 patients with other subtypes of AIS). CT and MRI, MR-angiography, ultrasound study as well as assessment of clinical symptoms on PedNIHSS were performed. The duration of follow-up was from 2 month to 14 years. The follow-up allowed the assessment of occurrence of secondary strokes, severity of residual neurological symptoms on the PSOM and fatal outcomes. Special attention was drawn to the use of CASSADE criteria for CES. RESULTS AND CONCLUSION: Clinical features that help to diagnose CES, even in the absence of adequate neuroimaging, in patients with heart disease, which is a potential high risk factor for cardioembolia, were established. These factors include early disease onset, acute development and progression of neurological deficit to the maximal level in the first 5 min., marked severity of the acute period (PedNIHSS > 15), early recovery of neurological functions, significant residual neurological symptoms (PSOM > 2). These symptoms should be used in addition to the CASCADE criteria in the diagnosis of CES of AIS type in children.

[Arterial ischemic stroke in children with mild head trauma]. / Arterial'nyĭ ishemicheskiĭ insul'ta u deteĭ s legkoĭ travmoĭ golovnogo mozga.

AIM: To study the relationship between mild head trauma (MHT) and arterial ischemic stroke (AIS) in children. MATERIAL AND METHODS: We examined 81 patients with AIS, aged from 1 month to 15 years. The sample was stratified into two groups: patients with AIS caused by MHT (main group) and patients without MHT (comparison group). RESULTS AND CONCLUSION: Based on the results of clinical and instrumental studies, we identified the relationship between AIS and MHT. The main group was characterized by the following features: moderate severity in the acute period, stabilization within 7 days, isolated subcortical localization of ischemic lesion, no MRI-signs of steno-occlusive cerebral arteriopathy and a trend towards the risk of recurrent strokes.

[Ophthalmologic symptomatology in children with periventricular leucomalation].

Ophthalmologic symptoms were analyzed in 76 children with periventricular leucomalation (PL). Clinical or functional ophthalmic disorders were detected in 100% of patients. Changes in the optic nerve disc were diagnosed in 93.4% of patients. The syndrome of dilated excavation (SDE), i.e. dilation and cupping of the optic nerve disc combined in all cases with affection of postgenicular visual paths (of optic radiation and/or striatal cortex) verified by neuroradiology, was most frequently (80.3%) encountered in children with PL. Presumably, the progression of SDE is associated with transsynaptic retrograde degeneration conditioned by the hypoxic-ischemic affection of the CNS in the projection of postgenicular visual paths at pre- and perinatal stages. SDE is an important criterion in the diagnosis of lesions of postgenicular visual paths in babies.

[Neuro-ophthalmological and radiological signs of Aicardi syndrome]. / Neirooftal'mologicheskie i radiologicheskie proiavleniia sindroma Ecardi.

Described in the paper are the results of ophthalmologic, ultrasound and radiological examinations of 3 girls with the Aicardi syndrome. It was for the first time, that an expansion of the optic-nerve disk excavation was described in patients with the above syndrome; such expansion was conditioned by trans-synaptic neuron degeneration induced by lesions to optic radiation in view of prenatal of encephaloplastic processes. The changing brain white substance as projected by optic radiation was detected in all children by computer and magnetic resonance tomography. Besides, other anomalies of the optic nerve (bindweed syndrome, coloboma) and of the retina are elucidated. Finally, the pathogenesis and differential diagnostics of the Aicardi syndrome are under discussion.

[Isolated aplasia of the optic nerve]. / Izolirovannaia aplaziia zritel'nogo nerva.

The results of ophthalmologic examinations, including ophthalmoscopy, ultrasound Doppler-graphy as well as neuroradiological and electrophysiological investigations, of a 6-month boy with bilateral isolated aplasia of the optic nerve are described. The discussion comprises a literature survey dedicated to pathogenesis and diagnostics of optic-nerve aplasia in children.