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[Risk factors in cerebrovascular disease in childhood]
E Cardo1, M Pineda, M A Vilaseca
1Servicio de Neuropediatría, Hospital Sant Joan de Déu-Hospital Clínic, Barcelona, España.
Insights
Pediatric cerebrovascular disease risk factors include viral infections, dehydration, and head injuries. Identifying these factors is crucial for timely intervention and prevention strategies in children.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Epidemiology
Background:
- Cerebrovascular diseases in children (paediatric cerebrovascular illness) have poorly understood and diverse causes.
- Existing literature offers limited practical guidance for investigating pediatric stroke cases.
Purpose of the Study:
- To identify risk factors for cerebrovascular accidents (CVAs) in the pediatric population.
- To establish clinical guidelines for managing pediatric stroke.
Main Methods:
- Retrospective study of pediatric patients diagnosed with ischemic or hemorrhagic cerebral infarct.
- Data collected from Hospital San Joan de Deú, Barcelona (1984-1995).
Main Results:
- 141 pediatric stroke cases identified; 60 specific causes found (cardiopathies most common).
- Risk factors identified in 66% of cases: viral infections, dehydration, head injuries, stress.
- Prethrombotic factors (32.8%) and anemia (29%) were noted. High anti-Cytomegalovirus (67.1%) presence, especially in non-survivors.
Conclusions:
- Identified key risk factors for pediatric cerebrovascular disease in the studied population.
- Pediatric stroke likely results from multiple interacting risk factors requiring structured diagnostic protocols.
- Recognizing these causes is vital for acute management and secondary prevention in children.
Introduction:
The etiopathogenesis of cerebrovascular diseases in paediatrics is little known and very varied. Review of the literature gives little practical information about how to investigate a paediatric patient who presents with an acute cerebrovascular illness.
Objectives:
To identify the risk factors for cerebrovascular accidents in the paediatric age group in our setting and establish guidelines as to how best to act.
Patients And Methods:
A retrospective study was made of the patients admitted to the Hospital San Joan de Deú in Barcelona between January 1984 and December 1995 with the diagnosis of ischemic or hemorrhagic cerebral infarct.
Results:
A total of 141 cases were identified. Sixty specific causes (43.7%) were detected, of which cardiopathies made up the biggest etiological group. Risk factors for cerebrovascular disease were found in 66% of the cases. The risk factors most often identified were association with non-specific (22) and specific (varicella: 7 cases) viral infections; moderate dehydration (10); mild head injuries (10) and situations of stress (9). There were prethrombotic factors in 32.8% of the patients and anaemia in 29%. The high percentage of the anti Cytomegalovirus (67.1%) was of doubtful significance, and the percentage rose to 82.8% in the patients who died (29/35). In this study the role of hyperhomo-cysteinemia and resistance to C activated protein could not be assessed.
Conclusions:
In this study we identified the risk factors for cerebrovascular disease in the paediatric age group of our population. Stroke in the paediatric age group is probably due to a combination of several risk factors which will need structured protocols for identification. It is important to recognize these causes so as to plan strategies for action during the acute phase and to prevent recurrence, as are currently available to the adult population.