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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Stroke in children. Clinical characteristics and prognosis
Insights
Childhood stroke, including hemorrhagic and ischemic types, requires prompt medical attention. Early diagnosis and specialized care are crucial for improving outcomes in pediatric stroke patients, despite significant mortality and disability rates.
Area of Science:
- Pediatric Neurology
- Cerebrovascular Diseases
- Childhood Stroke
Background:
- Childhood stroke, characterized by acute hemiplegia, is a significant concern.
- Prompt intervention is essential to improve patient outcomes.
Purpose of the Study:
- To investigate the clinical characteristics, incidence, and outcomes of stroke in children.
- To offer guidelines for the emergency management of pediatric stroke.
Main Methods:
- Retrospective analysis of 27 children diagnosed with stroke over a ten-year period.
- Inclusion of neuroradiological examinations and neurosurgical interventions where applicable.
- Analysis of clinical signs, preceding infections, and patient outcomes.
Main Results:
- Hemorrhagic stroke occurred in 14 cases, ischemic in 11; 2 cases of migraine accompagnée were also noted.
- Higher incidence of unilateral neurological signs in ischemic stroke (90%) versus hemorrhagic stroke (50%).
- Mortality rates were 36% for hemorrhagic and 18% for ischemic stroke, with 75% residual disability in survivors.
Conclusions:
- The average annual incidence of childhood stroke is 2.1/100,000.
- Emphasizes the risks of brain edema and lumbar puncture in pediatric stroke.
- Urgent transfer to a specialized neurosurgical and neuroradiological facility is critical for affected children.
Abstract:
Cerebrovascular disease with acute hemiplegia or "stroke" in childhood is not rare and every possible effort must be made in order to improve the outcome for these patients. Acute hemiplegia and disturbance of consciousness are the most common initial signs. Twenty-seven children, 13 girls and 14 boys, with stroke have been investigated during a ten-year period. Hemorrhagic stroke was diagnosed in 14 cases, and ischemic stroke in 11 cases. In addition two cases with migraine accompagnée have been included. Neuroradiological examination was performed in all children, and neurosurgery in 11 cases with hemorrhagic stroke. In the ischemic stroke group, 55% presented a history of preceding infection. Over 90% of the children showed unilateral neurological signs in connection with ischemic stroke compared to 50% in hemorrhagic stroke, while the reverse frequency was observed as regards disturbances of consciousness. The mortality was 36% in hemorrhagic stroke and 18% in ischemic stroke. Among the children who survived, residual disabilities amounted to 75%. None has suffered a second stroke. The average annual incidence in childhood of hemorrhagic and ischemic stroke is 2.1/100 000/year. Some clinical characteristics and rules in the emergency approach to the hemiplegic child have been offered. The development of brain edema and the risk associated with lumbar puncture is emphasized. A child with stroke must without delay be transported to a hospital with access to neurosurgical expertise and neuroradiological facilities such at CAT scan and angiography.
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