Ischemic stroke in children: a study of the associated alterations

Ranzan, Josiane; Rotta, Newra Tellechea

doi:10.1590/s0004-282x2004000400010

“…17-24. These differences are likely related to case ascertainment and the inclusion and exclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

“…In children, the reported incidence of seizures in the setting of acute stroke varies from 34 -53.8%. However, these studies were not population-based, and the defined time-frames for incidence of seizure were quite variable 17-24…”

mentioning

confidence: 99%

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Seizures are Common in the Acute Setting of Childhood Stroke: A Population-Based Study

Chadehumbe

¹

,

Khatri

²

,

Khoury

³

et al. 2009

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In our large population-based cohort, 3.1% of adults had seizures within the first 24 hours of acute stroke. The objective of our study was to determine a similar incidence in children and compare by stroke subtype. Stroke cases in children between 7/93-6/94, and 1/99-12/99 were retrospectively identified and abstracted. We identified 31 strokes during the two study periods, including 17 ischemic strokes, 12 intracerebral hemorrhages, and 2 subarachnoid hemorrhages. Seizures occurred within 24 hours of the stroke in 58% (18/31) of children. No significant differences where found in the rate of seizure by stroke subtype. The relative risk (95% CI) for seizure in the acute stroke setting in children vs. adults is 18 (95% CI: 13, 26). As compared to adults, seizures within the acute setting of childhood stroke are common with an occurrence rate in our population of 58%. Keywordsseizures; cerebrovascular disease; stroke; childhood The relationship between seizures and stroke was reported as early as 1864 by John Hughlings Jackson. 1 . Subsequent reports estimated an incidence of seizures after stroke of 0.4 to 43% in the adult population. [2][3][4][5][6][7][8][9][10][11][12][13] . In children, the reported incidence of seizures in the setting of acute stroke varies from 34 -53.8%. However, these studies were not population-based, and the defined time-frames for incidence of seizure were quite variable. [17][18][19][20][21][22][23][24] . In addition, there was great variability regarding patient attributes, diagnostic criteria, and duration of follow-up. In the Greater Cincinnati/ Northern Kentucky population, which is the basis of the current study, 3.1% of adults had seizures in the setting of acute stroke; seizures occurred more frequently in patients with hemorrhagic stroke. 15 . Research has identified stroke as a clear risk factor for seizure development in the elderly 14 , but in children this relationship has not been clearly established. [17][18][19][20][21][22][23][24] .

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“…Os sintomas mais comumente descritos incluem hemiparesia, redução do nível de consciência, e lesões nervosas cranianas. Uma série de casos envolvendo crianças maiores de 1 mês mostrou uma taxa de hemiparesia variando de 85 a 100% 64,65 . Outros sintomas incluem hemiplegia, monoparesia, disfagia, dor de cabeça, tontura e distúrbios visuais.…”

Section: Achados Clínicosunclassified

Stroke in children

Filho¹,

Carvalho²

2009

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Objectives: To summarize 1) the definitions and epidemiological features of stroke in children; 2) the main risk factors that can lead to stroke in pediatrics and neonatology; 3) the main pathophysiological features involved in the genesis of brain injury in stroke; 4) the clinical manifestations and imaging diagnosis; and 5) the latest recommendations concerning the support measures, treatment, and prophylaxis of stroke in children.Sources: A review of the literature published in PubMed, EMBASE, and SciELO databases using the search terms stroke, pediatrics, and neonatology was performed, including relevant references from the chosen texts. Summary of the findings:Stroke in children are rare conditions, with incidence rates among two and eight per 100,000 children up to 14 years, and most cases show an underlying disease such as heart diseases, prothrombotic conditions, sickle-cell disease, and vascular malformations. There are no specific guidelines currently in place for the treatment of stroke in children, although central elements include support treatment, monitoring, and anticoagulation as secondary prevention in certain cases. Prognosis depends on the extent of brain damage and the underlying disease but recurrence rates are high in most cases. Conclusions:Early diagnosis of stroke in children is very important and pediatricians should be aware of the lack of specificity of the symptoms to avoid late sequelae and improve life quality.J Pediatr (Rio J). 2009;85(6):469-479: Stroke, pediatrics, neonatology, intensive care, anticoagulants. ResumoObjetivos: Listar 1) as definições e características epidemiológicas de acidentes vasculares encefálicos (AVE) em crianças; 2) os principais fatores de risco para a ocorrência de AVE em pediatria e neonatologia; 3) as principais características fisiopatológicas para a ocorrência de lesão cerebral no AVE; 4) as manifestações clínicas e o diagnóstico por imagem; e 5) as recomendações atualizadas para as medidas de suporte, tratamento e profilaxia dos AVE em pediatria. Fontes dos dados:Realizou-se revisão da literatura nas bases de dados PubMed, EMBASE e SciELO utilizando-se como palavras-chave stroke, pediatrics e neonatology, além da utilização de referências bibliográficas importantes dos textos escolhidos. Síntese dos dados:A ocorrência de AVE em pediatria é incomum, com a incidência variando entre duas e oito por 100.000 crianças abaixo de 14 anos, tendo a maioria como denominador comum a ocorrência de doenças de base como cardiopatias congênitas, anemia falciforme e malformações vasculares. Não há padronização nas recomendações de tratamento para o AVE em crianças, embora as medidas fundamentais incluam monitoração, tratamento de suporte e anticoagulação em casos selecionados. O prognóstico depende da extensão de área cerebral acometida e da doença de base, mas as taxas de recorrência são altas na maioria dos casos. Conclusões:O diagnóstico precoce dos AVE em pediatria é fundamental, e é importante que os pediatras estejam atentos à falta de especificidade...

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“…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.…”

Section: Clinical Findingsmentioning

confidence: 99%

Acidentes vasculares encefálicos em pediatria

Filho¹,

Carvalho²

2009

J. Pediatr. (Rio J.)

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Objectives: To summarize 1) the definitions and epidemiological features of stroke in children; 2) the main risk factors that can lead to stroke in pediatrics and neonatology; 3) the main pathophysiological features involved in the genesis of brain injury in stroke; 4) the clinical manifestations and imaging diagnosis; and 5) the latest recommendations concerning the support measures, treatment, and prophylaxis of stroke in children.Sources: A review of the literature published in PubMed, EMBASE, and SciELO databases using the search terms stroke, pediatrics, and neonatology was performed, including relevant references from the chosen texts. Summary of the findings:Stroke in children are rare conditions, with incidence rates among two and eight per 100,000 children up to 14 years, and most cases show an underlying disease such as heart diseases, prothrombotic conditions, sickle-cell disease, and vascular malformations. There are no specific guidelines currently in place for the treatment of stroke in children, although central elements include support treatment, monitoring, and anticoagulation as secondary prevention in certain cases. Prognosis depends on the extent of brain damage and the underlying disease but recurrence rates are high in most cases. Conclusions:Early diagnosis of stroke in children is very important and pediatricians should be aware of the lack of specificity of the symptoms to avoid late sequelae and improve life quality.

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Ischemic stroke in children: a study of the associated alterations

Cited by 15 publications

References 27 publications

Seizures are Common in the Acute Setting of Childhood Stroke: A Population-Based Study

Seizures are Common in the Acute Setting of Childhood Stroke: A Population-Based Study

Stroke in children

Acidentes vasculares encefálicos em pediatria

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