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[Ischemic cerebrovascular accidents in childhood. Problems of neuroradiological diagnosis]
Insights
Pediatric stroke causing hemiplegia can occur without clear causes or blood abnormalities. Imaging like CT scans often reveals ischemic lesions, but the exact cause of stroke in children remains uncertain.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Stroke with subsequent hemiplegia in children is a significant neurological event.
- The underlying causes and risk factors in pediatric stroke are often complex and multifactorial.
- Identifying the etiology is crucial for appropriate management and prognosis.
Purpose of the Study:
- To investigate the clinical characteristics and diagnostic findings in a cohort of children experiencing stroke with hemiplegia.
- To explore potential correlations between hematologic alterations and stroke occurrence.
- To evaluate the utility of neuroimaging techniques in identifying vascular lesions in pediatric stroke.
Main Methods:
- Retrospective case series of 19 children diagnosed with stroke and subsequent hemiplegia.
- Clinical data including age, hematologic parameters, and predisposing factors were reviewed.
- Cerebral angiography was performed in 16 patients.
- Computed Tomography (CT) scans were conducted in 17 patients.
Main Results:
- The age range of affected children was 5 months to 15 years.
- Stroke cases showed no strict correlation with hematologic alterations.
- Cerebral angiography revealed vascular alterations in only 6 out of 16 cases.
- CT scans demonstrated low-density areas, indicative of ischemic lesions, in 12 out of 17 examined cases.
Conclusions:
- The aetiopathogenesis of stroke with hemiplegia in children remains uncertain in many cases, even in the absence of identifiable predisposing causes or anatomical vascular lesions.
- Neuroimaging, particularly CT scans, can reveal ischemic changes consistent with stroke, but angiography is not always diagnostic for vascular abnormalities.
- Further research is needed to elucidate the specific mechanisms underlying pediatric stroke and hemiplegia.
Abstract:
The authors present 19 cases of stroke with subsequent hemiplegia in children from 5 months to 15 years of age. These cases are not strictly correlated with haematologic alterations. The aetiopathogenesis remains uncertain in the most of patients, in which predisposing causes are absent and angiographic pictures do not demonstrate anatomical lesions or occlusions of cerebral vessels. In our series, cerebral angiography was performed in 16 children and showed vascular alterations only in 6 cases. CT scan some time after the acute hemiplegia, demonstrated low-density areas in 12 cases over 17 examined, with the characteristic evolution of ischemic lesions.