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Strokes in children: a medical center-based study
1Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Insights
Pediatric stroke, a significant cause of child mortality, presents with motor deficits and consciousness changes. Early diagnosis and aggressive treatment are crucial for improving outcomes in childhood stroke.
Area of Science:
- Neurology
- Pediatrics
- Clinical Medicine
Background:
- Stroke is a major cause of mortality and morbidity in children.
- Understanding the diverse causes and outcomes of pediatric stroke is critical for effective management.
Purpose of the Study:
- To analyze the clinical characteristics, underlying diseases, and outcomes of pediatric stroke.
- To differentiate between ischemic and hemorrhagic stroke in children.
Main Methods:
- Retrospective review of 65 pediatric stroke cases (excluding those related to prematurity, birth trauma, or head injury) admitted between 1985 and 1995.
- Classification of patients into ischemic (38) and hemorrhagic (27) stroke groups.
- Systematic analysis of age of onset, clinical presentation, predisposing conditions, and treatment.
Main Results:
- Motor deficit and consciousness disturbance were the most common presenting symptoms in both stroke types.
- Vascular malformations and oncologic conditions were primary causes of hemorrhagic stroke.
- Oncologic conditions were the most frequent underlying disease in ischemic stroke; mortality rates were 37% for hemorrhagic and 21.1% for ischemic stroke.
Conclusions:
- Pediatric stroke exhibits male predominance and diverse underlying pathologies.
- While clinical signs offer clues, neuroimaging is essential for accurate diagnosis.
- Prompt diagnosis and aggressive treatment strategies are vital for managing pediatric stroke effectively.
Abstract:
Stroke is an important cause of mortality and morbidity in children. Cases of pediatric stroke admitted to National Taiwan University Hospital from January 1985 to December 1995 were reviewed. Patients whose stroke was obviously caused by premature birth, birth trauma or head injury were excluded. Totally 65 patients were enrolled, including 37 boys and 28 girls. Their ages ranged from birth to 18 years old. They were classified into two groups: ischemic stroke (38 patients) and hemorrhagic stroke (27 patients), according to the pathogenesis. The ages of onset, clinical manifestation, underlying diseases and treatment of these two groups were systematically analyzed. The major presenting symptoms of both ischemic and hemorrhagic strokes were motor deficit (65.8%) and consciousness disturbance (55.6%). A wide variety of diseases predisposing to strokes was identified. The major causes of hemorrhagic stroke were vascular malformation and oncologic conditions, with the latter, the most frequently encountered underlying diseases associated with childhood ischemic stroke. The mortality rate for hemorrhagic stroke was 37% and, for ischemic stroke, 21.1%. There was male predominance in pediatric stroke. Although the clinical symptoms and signs might provide some guidelines to differentiate between hemorrhagic and ischemic strokes, neuroimaging studies were crucial to more exact diagnosis. A variety of diseases may contribute to pediatric stroke. Early diagnosis determine treatability, then aggressive treatment are important.