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[Intraparenchymal hematomas: specific features in children]
M E Marzo-Sola1, J Carod-Artal, C Garaizar
1Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España.
Insights
Pediatric intraparenchymatous hemorrhage has a high mortality rate (20%) and significant long-term neurological deficits, comparable to elderly individuals. Arteriovenous malformations are the primary cause in children.
Area of Science:
- Neurology
- Pediatrics
- Vascular Malformations
Context:
- Intraparenchymatous hemorrhages are uncommon but severe in infants.
- Pediatric hemorrhages differ significantly from adult cases in cause and outcome.
Purpose:
- To analyze the characteristics of spontaneous intraparenchymatous hemorrhage in children.
- To compare pediatric hemorrhage outcomes with adult populations.
Summary:
- A 10-year review of pediatric patients (<13 years) with intraparenchymatous hemorrhage identified 10 cases.
- The leading cause was arteriovenous malformations (70%), followed by liver disorders, tumors, and idiopathic cases.
- Outcomes included 20% mortality, 60% neurological deficits, and 20% no sequelae.
Impact:
- Pediatric intraparenchymatous hemorrhage carries a substantial mortality (20%) and morbidity, similar to elderly patients.
- Arteriovenous malformations are the predominant etiology in pediatric cases.
- Findings highlight the critical need for prompt diagnosis and management in pediatric neurovascular emergencies.
Introduction:
Intraparenchymatous haemorrhages are rare in infancy, but their effects may be very harmful. The aetiology, clinical characteristics and prognosis regarding life and function are different from those in adults.
Objective:
We decided to analyze the characteristics of this pathology in children and compare them with those in adults.
Material And Methods:
We reviewed the clinical histories of the patients under 13 years of age presenting with a spontaneous intraparenchymatous haemorrhage during a 10 year period.
Results:
The study group was made up of 10 patients, 5 boys and 5 girls, aged between 23 days and 11 years. In 7 patients the aetiology was a burst arteriovenous malformation; in one a serious liver disorder due to alpha-l-antitrypsin deficiency; bleeding from an undiagnosed tumour caused another case and no aetiology was found in a further case. Two patients died, 6 patients had residual neurological defects and in the other two there were no sequelae.
Conclusions:
Intraparenchymatous haematomas in children have a high mortality (20%) and many sequelae. The figures are comparable with those for elderly persons aged over 70 and much greater than in the case of young adults. The commonest aetiology is an arteriovenous malformation, followed at a considerable distance by coagulopathies and tumours.