Cerebrovascular disease in pediatric patients

Abstract

Although rare in childhood, stroke may have a serious impact when it happens in this stage of life. Also, it may be the first sign of a systemic disease. We report 12 cases of patients with stroke treated in the Neuropediatrics Unit of Hospital de Clínicas de Porto Alegre (HCPA) from March 1997 to March 2000. All patients, from term infants to 12-year-old children hospitalized in the Pediatrics Unit of HCPA, had clinical suspicion of stroke, which was later confirmed by radiological studies. Patient follow up ranged from 1 to 6 years (mean = 3.4 years). Presenting symptoms were hemiparesis in 9 patients, seizures in 7, deviation of labial commissure in 3, and loss of consciousness in 1. The increase in the number of cases of childhood stroke identified and later confirmed by noninvasive methods had helped in the determination of different ethiologies of stroke: the most frequent being hematologic, cardiac and genetic diseases. However, our study included 6 newborns with stroke whose ethiology was not identified. Seven children with seizures received phenobarbital. Six term infants had neonatal seizures secondary to stroke and restricted to the first 72 hours of life.

Ischemic stroke in children: a study of the associated alterations

“…This fact agrees with our research in which more than a third in which of the population has perinatal AIS. Other researches show that AIS occurs in this age period in between 20 and 50% of the entire sample 3,6,11 . In this study the average age at which AIS occurred in the post birth period was 2 years and 6 months which disagrees with other studies in which the occurrence age was at 5 years 12,13 and this suggests that, as time goes on, this pathology is being diagnosed earlier.…”

“…The rate of incidence has increased from 1.2 to 2.7 per 100000 children/year 1,2 . The typical clinical presentation of AIS is a prolonged focal neurologic deficit, of acute onset, as for example, hemiparesis 3 . Seizures also may be the first manifestation 4 especially in the newborn 1,3 .…”

“…The typical clinical presentation of AIS is a prolonged focal neurologic deficit, of acute onset, as for example, hemiparesis 3 . Seizures also may be the first manifestation 4 especially in the newborn 1,3 . Sometimes, the cause of AIS is easily defined especially when the patient has a basic disease such as sickle cell disease or congenital heart disease.…”

Cerebral infarct in children aged zero to fifteen years

“…We did not find newborn infants in the present series, probably due to difficulties in performing imaging exams during the acute phase of the disease at this time during the investigation. In newborn infants, when peri-intraventricular hemorrhages are excluded, cerebrovascular disease more frequently presents convulsive seizures as the initial manifestation 8,9 .…”

Acidentes vasculares encefálicos em pediatria

“…Case series involving children older than 1 month show a rate of hemiparesis ranging from 85 to 100%. 64,65 Other symptoms include hemiplegia, monoparesis, dysphasia, headache, dizziness, and visual disturbances.…”