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[Neuropsychological problems of cerebrovascular pathology in children]
P Barbero1, M Téllez De Meneses
1Hospital Infantil La Fe, Valencia, España. med001976@nacom.es
Insights
Infantile cerebrovascular pathology, though infrequent, significantly impacts long-term neurological and psychological outcomes. Peri/intraventricular hemorrhages (PIVH) in premature infants are a growing concern requiring specialized monitoring.
Area of Science:
- Pediatric Neurology
- Vascular Biology
- Neonatology
Context:
- Cerebrovascular pathology in infants is rare but critical.
- Distinguishes between congenital malformations and acquired lesions.
- Highlights peri/intraventricular hemorrhages (PIVH) as a major concern in premature infants.
Purpose:
- To underscore the importance of infantile cerebrovascular diseases.
- To categorize the origins of these pathologies.
- To emphasize the rising incidence of PIVH due to increased preterm multiple births.
Summary:
- Infantile cerebrovascular lesions can lead to lifelong neurological and psychological sequelae.
- Peri/intraventricular hemorrhages (PIVH) are the most frequent and severe, particularly in premature and low-birth-weight neonates.
- The incidence of PIVH is increasing, linked to advances in neonatal care and multiple preterm births.
Impact:
- Early and continuous neuropaediatric monitoring is essential for affected infants.
- Timely detection and management of sequelae are crucial.
- Requires multidisciplinary collaboration among neuropaediatricians, psychologists, educators, and physiotherapists for comprehensive care.
Abstract:
Cerebrovascular pathology in infancy is, unlike in adults, infrequent. However, this must not lead us to think it is unimportant. There are a number of different vascular processes that exert an influence to varying degrees on the neurological and psychological future of our young patients. These sequelae can be of more or less importance and, on some occasions, can be lesions that will accompany them throughout the rest of their lives, in spite of the therapeutic methods we have available today. We basically differentiate vascular organic lesions that are pre-established or due to malformations from other causes acquired as a consequence of an anomalous situation inherent to other pathologies and that have an extravascular origin. The most striking of these, because of their frequency, gravity and cellular pathology, are peri/intraventricular haemorrhages (PIVH) in those born premature and those weighing very little at birth. The causes from malformations remain and are relatively rare with a stable frequency, while the number of cases of PIVH has risen sharply in recent years due to different causes, the most notable of which is the increase in preterm multiple births, at around 30-32 weeks of gestation. This group of the population requires early and continuous neuropaediatric monitoring. Some of the sequelae are detected and dealt with quickly; others may appear later and will need the joint, coordinated attention of neuropaediatricians, psychologists, educators and physiotherapists.