Risk Factors and Imaging Characteristics of Childhood Stroke in China

Deng, Yaxian; Wang, Yilong; Yang, Weili; Yu, Yazhen; Xu, Jin; Wang, Yongjun; Gao, Beile

doi:10.1177/0883073814538667

Cited by 22 publications

(22 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study confirms the results of previous studies describing childhood AIS as a multiple risk disease [13,16,25]. The proportion of cases with prothrombotic states exceeds the numbers reported in previous studies (0-25 %) [2,13,16,18,25,30]. It is unclear whether this reflects diagnostic bias in health care systems with structures which do not allow for the unrestrained use of laboratory diagnostics.…”

Section: Discussionsupporting

confidence: 85%

“…Many patients present with more than one symptom, leading to a challenge in differential diagnoses. Most of the previous reports on pediatric stroke have reported cumulative symptoms for stroke patients [2,13,18,25,30]. Characterising the leading symptoms and common symptom combinations for the different age groups of children suffering arterial ischemic stroke might allow for earlier recognition and possibly earlier diagnosis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Symptom patterns in childhood arterial ischemic stroke: Analysis of a population-based study in Germany

Gerstl¹,

Weinberger²,

Kries³

et al. 2018

Klin Padiatr

View full text Add to dashboard Cite

Hintergrund Die zeitliche Verzögerung zwischen Symptombeginn und Diagnose ist eine Herausforderung in der Behandlung von Kindern mit arteriell ischämischem Schlaganfall. Frühere Studien zur klinischen Präsentation beschäftigten sich v. a. mit kumulativen Symptomen. Zielsetzung Ziel dieser Studie ist es, mögliche Symptommuster aufzuzeigen. Methoden In einer aktiven Beobachtungsstudie zwischen 01/2015 und 12/2016 (ESPED-Studie) wurden Kinder mit Erstdiagnose eines arteriell ischämischen Schlaganfalls eingeschlossen. Isoliert auftretende Erstsymptome wurden verschiedenen Symptomkombinationen gegenübergestellt. Zudem wurde untersucht, inwieweit ein als „akut“ oder „progredient“ klassifiziertes Auftreten der Symptome Rückschlüsse auf die zugrundeliegende Ätiologie erlaubt. Ergebnisse Es wurden 99 Kinder in die Studie eingeschlossen. Unabhängig vom Alter traten überwiegend fokale Symptome auf (86%). Krampfanfälle als Initialsymptom wurden insbesondere bei Säuglingen beschrieben (67%), wohin-gegen diffuse, unspezifische Symptome vor allem bei Vorschulkindern (38%) und älteren Kindern (59%) auftraten. Isoliert traten fokale Symptome bei 37 Kindern auf, 48 Kinder zeigten zusätzlich unspezifische Symptome, darunter auch 9 Kinder mit Krampfanfällen. Isolierte unspezifische Symptome zeigten sich lediglich bei 7 Kindern, 2 Kinder wurden nur mit Krampfanfällen symptomatisch. Die Akuität des Symptombeginns wurde bei 53/78 als „akut“ und bei “25/78 Fällen als „progredient“ klassifiziert, lieferte jedoch keinen Hinweis auf die zugrundeliegende Ätiologie. Schlussfolgerung Jedes neue fokal neurologische Defizit sollte unabhängig vom Auftreten (isoliert oder kombiniert, akut oder progredient) an einen kindlichen Schlaganfall denken lassen. Background Time delay between onset of clinical symptoms and diagnosis is a challenge in childhood arterial ischemic stroke. Most previous studies reported cumulative symptoms. Objective We attempted to identify typical symptom patterns and assessed their emergence in childhood stroke. Methods Prospective active surveillance in ESPED, a hospital based Pediatric Surveillance Unit for rare diseases in Germany, between January 2015 and December 2016. Case definition: first diagnosis of a radiologically confirmed arterial ischemic stroke. Symptom patterns were identified as occurring in isolation or in combination. We distinguished acute vs. progressive onset. We ascertained risk factors to identify the possible etiology. Results 99 children with childhood arterial ischemic stroke were reported. Focal symptoms were the predominant presenting feature (86%), independent of age. Seizures were more often seen in infants < 1 year (67%), whereas diffuse symptoms were more present in pre-school children (38%) and older children (59%). 37 children had focal features alone and 48 additional non-specific features, including 9 with seizures. Isolated non-specific features accounted for 7 cases, and 2 children had (focal) seizures as the only symptom. In 77% of all cases at least one risk factor was identified. The emergence of symptoms was acute in 53/78 cases and progressive in 25/78 cases. The pattern of emergence was unrelated to the underlying etiology. Conclusions Any new focal neurological deficit in isolation, or associated with seizures or further non-specific symptoms should alert to childhood stroke.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Symptom patterns in childhood arterial ischemic stroke: Analysis of a population-based study in Germany

Gerstl¹,

Weinberger²,

Kries³

et al. 2018

Klin Padiatr

View full text Add to dashboard Cite

show abstract

“…The result of the present study also described the same results. The most common risk factor in our series was cardiac disorders (32.5%), which is almost close to the results of the study in the Chinese population (2,12), while this number was reported nearly as twice from the previous studies in Iran (11,13). On the other hand, Masri and coworkers indicated that neurometabolic disorders were the main causes of strokes in Jordanian children (16).…”

Section: Discussion and Review Of Literaturesupporting

confidence: 72%

Pediatric Stroke in Southern Iran; Clinical Presentations, Etiologies and Outcomes: A Case-Series and Review of Literature

et al. 2018

View full text Add to dashboard Cite

Background: Pediatric stroke is defined as rapid developing clinical signs of focal (or global) disturbance of cerebral function without any apparent cause other than of vascular origin lasting for 24 hours or longer in the ages of 1 month to 18 years. It is relatively rare in children, however, it can lead to significant mortality and morbidity. Objectives: The present study aimed to identify clinical presentations, etiologies, and outcomes of pediatric stroke in southern Iran. Methods: This case-series study included all patients that were diagnosed with a pediatric stroke and admitted to the Pediatric Neurology ward at Namazi hospital in Shiraz, Iran, from May 2009 through March 2012. Results: During the study period, 40 newly diagnosed patients (27 males and 13 females) between the ages of 10 months and 18 years old were identified. The most prevalent referring symptoms were hemiparesis and hemiplagia (65%), seizures (45%), speech difficulties (42.5%), and altered mental status (35%). A known single etiology was identified in 82.5% of patients. The most common single risk factor was cardiac abnormalities with 30% frequency, followed by idiopathic and vascular with 17.5%. The outcome of pediatric patients revealed incomplete recovery with moderate neurological deficits (45%) including residual epilepsy (15%), speech difficulties (15%), and behavioral dysfunction (7%), which indicate their need for help in some of their daily activities. Conclusions: Stroke in southern Iranian pediatric patients demonstrated different patterns of causes and risk factors with similar clinical presentations and outcomes.

show abstract

“…The greatest number of deaths was contributed by HS, and overall burden in childhood stroke was greater in HS than IS. There is a lack of population-based estimates of stroke incidence and mortality in developing countries although some data are available [37][38][39] , and very few that have studied temporal trends; a hospital-based study of childhood stroke showed similar proportions of HS to IS and a greater burden in men [40] . These findings reflect existing evidence on the greater burden of HS in children.…”

Section: Discussionmentioning

confidence: 99%

Stroke Prevalence, Mortality and Disability-Adjusted Life Years in Children and Youth Aged 0-19 Years: Data from the Global and Regional Burden of Stroke 2013

et al. 2015

View full text Add to dashboard Cite

Background: There is increasing recognition of stroke as an important contributor to childhood morbidity and mortality. Current estimates of global childhood stroke burden and its temporal trends are sparse. Accurate and up-to-date estimates of childhood stroke burden are important for planning research and the resulting evidence-based strategies for stroke prevention and management. Objectives: To estimate the prevalence, mortality and disability-adjusted life years (DALYs) for ischemic stroke (IS), hemorrhagic stroke (HS) and all stroke types combined globally from 1990 to 2013. Methodology: Stroke prevalence, mortality and DALYs were estimated using the Global Burden of Disease 2013 methods. All available data on stroke-related incidence, prevalence, excess mortality and deaths were collected. Statistical models and country-level covariates were employed to produce comprehensive and consistent estimates of prevalence and mortality. Stroke-specific disability weights were used to estimate years lived with disability and DALYs. Means and 95% uncertainty intervals (UIs) were calculated for prevalence, mortality and DALYs. The median of the percent change and 95% UI were determined for the period from 1990 to 2013. Results: In 2013, there were 97,792 (95% UI 90,564-106,016) prevalent cases of childhood IS and 67,621 (95% UI 62,899-72,214) prevalent cases of childhood HS, reflecting an increase of approximately 35% in the absolute numbers of prevalent childhood strokes since 1990. There were 33,069 (95% UI 28,627-38,998) deaths and 2,615,118 (95% UI 2,265,801-3,090,822) DALYs due to childhood stroke in 2013 globally, reflecting an approximately 200% decrease in the absolute numbers of death and DALYs in childhood stroke since 1990. Between 1990 and 2013, there were significant increases in the global prevalence rates of childhood IS, as well as significant decreases in the global death rate and DALYs rate of all strokes in those of age 0-19 years. While prevalence rates for childhood IS and HS decreased significantly in developed countries, a decline was seen only in HS, with no change in prevalence rates of IS, in developing countries. The childhood stroke DALY rates in 2013 were 13.3 (95% UI 10.6-17.1) for IS and 92.7 (95% UI 80.5-109.7) for HS per 100,000. While the prevalence of childhood IS compared to childhood HS was similar globally, the death rate and DALY rate of HS was 6- to 7-fold higher than that of IS. In 2013, the prevalence rate of both childhood IS and HS was significantly higher in developed countries than in developing countries. Conversely, both death and DALY rates for all stroke types were significantly lower in developed countries than in developing countries in 2013. Men showed a trend toward higher childhood stroke death rates (1.5 (1.3-1.8) per 100,000) than women (1.1 (0.9-1.5) per 100,000) and higher childhood stroke DALY rates (120.1 (100.8-143.4) per 100,000) than women (90.9 (74.6-122.4) per 100,000) globally in 2013. Conclusions: Globally, between 1990 and 2013, there was a significa...

show abstract

Risk Factors and Imaging Characteristics of Childhood Stroke in China

Cited by 22 publications

References 26 publications

Symptom patterns in childhood arterial ischemic stroke: Analysis of a population-based study in Germany

Symptom patterns in childhood arterial ischemic stroke: Analysis of a population-based study in Germany

Pediatric Stroke in Southern Iran; Clinical Presentations, Etiologies and Outcomes: A Case-Series and Review of Literature

Stroke Prevalence, Mortality and Disability-Adjusted Life Years in Children and Youth Aged 0-19 Years: Data from the Global and Regional Burden of Stroke 2013

Contact Info

Product

Resources

About