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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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[Stroke in children. Experience in an emergency service]

Malka Huici-Sánchez1, Laura Escuredo-Argullós, Victoria Trenchs-Sáinz de la Maza

  • 1Hospital Sant Joan de Deu, 08950 Esplugues de Llobregat, Espana.

Revista De Neurologia
|July 18, 2014
PubMed

Insights

Cerebrovascular disease (CVD) is rare in children but has high morbidity and mortality. Haemorrhagic CVD presents with intracranial hypertension signs, while ischaemic CVD shows more neurological focal deficits.

Area of Science:

  • Pediatric Neurology
  • Cerebrovascular Diseases
  • Emergency Medicine

Background:

  • Cerebrovascular disease (CVD) is an uncommon yet significant cause of morbidity and mortality in children.
  • Understanding the specific characteristics of paediatric CVD is crucial for timely diagnosis and management.
  • Distinguishing between ischaemic and haemorrhagic CVD in children is essential for appropriate treatment strategies.

Purpose of the Study:

  • To characterize cerebrovascular disease (CVD) in paediatric patients presenting to an emergency department.
  • To identify clinical distinctions between ischaemic and haemorrhagic CVD in the paediatric population.
  • To analyze the aetiology, clinical presentation, and outcomes of paediatric CVD.

Main Methods:

  • A retrospective observational study was conducted over 10 years (2001-2011) in a tertiary care hospital's paediatric emergency department.
  • Included were 61 patients aged 1 month to 18 years with a final diagnosis of CVD.
  • Excluded were haemorrhages from trauma or tumours, venous sinus thrombosis, and patients not treated within the department.

Main Results:

  • The study included 61 paediatric patients (63.9% male, mean age 4.6 years).
  • Haemorrhagic CVD (57.4%) was more common than ischaemic CVD (42.6%).
  • Headache and vomiting were more frequent in haemorrhagic CVD, while hemiparesis and facial palsy were more common in ischaemic CVD. Arteriovenous malformations were the main cause of haemorrhagic CVD, and arteriopathies of ischaemic CVD. High rates of disability (44.3%) and mortality (9.8%) were observed.

Conclusions:

  • Cerebrovascular disease in children is rare but associated with substantial morbidity and mortality.
  • Haemorrhagic CVD slightly predominates and typically presents with signs of intracranial hypertension.
  • Ischaemic CVD more frequently manifests with focal neurological deficits.
Abstract

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