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[Ischemic cerebral apoplexy in children]
A Jung1, A Wagner, K V Andersen
1H:S Rigshospitalet, Juliane Marie Centeret, neuroradiologisk afdeling.
Ugeskrift for Laeger
|November 9, 2000
Summary
Pediatric cerebral ischemic stroke, often linked to endocarditis or trauma, can cause hemiparesis and lasting deficits in children. Early diagnosis through clinical and neuroradiological evaluation is crucial for effective management.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Pediatric Stroke
Background:
- Cerebral ischemic stroke in children is a significant cause of acquired childhood brain injury.
- Identifying predisposing factors and clinical presentations in pediatric stroke is essential for timely diagnosis and management.
- While less common than in adults, pediatric stroke requires specific diagnostic and therapeutic approaches.
Purpose of the Study:
- To identify predisposing factors, clinical characteristics, and outcomes of cerebral ischemic stroke in children.
- To investigate the role of vascular abnormalities in pediatric ischemic stroke.
- To emphasize the importance of early clinical and neuroradiological investigations.
Main Methods:
- Retrospective case series of eight children aged 1.5-10 years diagnosed with cerebral ischemic stroke over two years.
- Clinical data collection including medical history, symptoms, predisposing factors, and neurological examination.
- Vascular imaging (e.g., angiography) to assess for arterial stenoses or occlusions.
- Review of medical records for associated conditions like infections and coagulopathies.
Main Results:
- Eight children (1.5-10 years) experienced cerebral ischemic stroke; seven were previously healthy.
- Predisposing factors included endocarditis and trauma; varicella-zoster infection preceded stroke in five children.
- Common presentation was acute hemiparesis; seven children had middle cerebral or basilar artery stenosis/occlusion.
- Five children had persistent deficits; no deaths occurred. Coagulopathies, hypertension, arteriosclerosis, and patent foramen ovale were absent.
Conclusions:
- Cerebral ischemic stroke in children can be associated with specific predisposing factors and vascular pathologies.
- Varicella-zoster infection may be a relevant preceding event in pediatric ischemic stroke.
- Prompt clinical assessment and advanced neuroimaging are critical for diagnosing pediatric ischemic stroke and guiding treatment.