Risk of stroke in children

Fullerton, Heather J.; Wu, Yvonne W.; Zhao, Shoujun; Johnston, S. Claiborne

doi:10.1212/01.wnl.0000078894.79866.95

Cited by 506 publications

(430 citation statements)

References 39 publications

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“…The overall AIS mortality of 16% during the 5-year study period is similar to that in other reports [7,8]; however, when stroke occurred in the ICU, mortality was 40% and in non-critically ill children, stroke mortality was 3%. In most cases, death was related to the underlying medical illness rather than to the stroke (Table 2).…”

Section: Discussionsupporting

confidence: 88%

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Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign

Jordan¹,

Beek²,

Gottesman³

et al. 2007

Pediatric Neurology

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A consecutive case series of 55 children (0-17 years old) with arterial ischemic stroke is reported. Twenty of these children were critically ill at the time their stroke occurred. Mortality among these 20 children was 40%, as compared to 3% in non-critically ill children with arterial ischemic stroke; overall mortality in this case series was 16%. Mortality resulted primarily from the underlying illness. Prognosis after stroke is markedly worsened in children with premorbid critical illness.

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Section: Discussionsupporting

confidence: 88%

“…The others died of non-neurologic causes. Using a California-wide hospital discharge database there was a 16.5% case fatality rate for all first admissions for childhood ischemic stroke [8]. Severity of illness and cause of death were not mentioned and presumably these data were not available.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign

Jordan¹,

Beek²,

Gottesman³

et al. 2007

Pediatric Neurology

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“…In 2004, Fullerton et al 4 reported a significant decline in the annual rates of admissions for a first stroke among Californian children with SCD following repeated TCD examinations and the implementation of a blood transfusion program. They found that the rate for a first stroke was 0.88/100 person-years in 1991 -1998 compared to 0.50/100 person-years in 1999 and 0.17/100 person-years in 2000.…”

mentioning

confidence: 99%

Patients with sickle cell disease are frequently excluded from the benefits of transcranial doppler screening for the risk of stroke despite extensive and compelling evidence

Rodrigues

Adegoke

Campos

et al. 2017

Arq. Neuro-Psiquiatr.

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Transcranial doppler (TCD) is a strategic component of primary stroke prevention in children with sickle cell disease (SCD). This study was conducted to examine the TCD characteristics of children with SCD in nine different medical centers in Brazil. Methods: Transcranial doppler was performed in accordance with the Stroke Prevention Trial in Sickle Cell Anemia Protocol. Results: Of the 396 patients, 69.5% had homozygous SS hemoglobin. The TCD result was abnormal in 4.8%, conditional in 12.6%, inadequate in 4.3% and abnormally low in 1% of patients. The highest mean flow velocities were 121±23.83cm/s and 124±27.21cm/s in the left and right middle cerebral artery respectively. A total of 28.8% patients (mean age 9.19±5.92 years) were evaluated with TCD for the first time. Conclusions: The SCD patients were evaluated with TCD at an older age, representing an important missed opportunity for stroke prevention. Since TCD screening in patients with SCD is important to detect those at high risk for stroke, it is recommended that this screening should be made more readily available.

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“…Está descrita uma incidência de AVC hemorrágico na população pediátrica do estado da Califórnia de 1,1 em 100 mil pessoas por ano, sendo que quase metade dos AVC em idade pediátrica foram de natureza hemorrá-gica. 21 De acordo com vários autores as malformações arteriovenosas são responsáveis por 14% a 46% dos casos de AVC hemorrágico nesta faixa etária, ao contrário do adulto em que predominam a hipertensão arterial e angiopatia amiloide. Foi necessária intervenção neurocirúrgica na maioria dos doentes admitidos na unidade.…”

Section: Discussionunclassified

Acidentes Vasculares Cerebrais em Idade Pediátrica: O Papel dos Cuidados Intensivos

Ferreira

Rebelo

Aguilar

et al. 2017

Acta Pediátrica Port

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Acta Pediatr Port 2017;48:245-52Resumo Introdução: As lesões vasculares do sistema nervoso central, nomeadamente o acidente vascular cerebral hemorrágico, o acidente vascular cerebral isquémico e trombose venosa cerebral, são causa importante de morbilidade e mortalidade. Existem poucos estudos sobre a melhor abordagem terapêutica em pediatria. O objetivo deste estudo foi descrever a abordagem e outcome neurológico dos doentes admitidos numa unidade de cuidados intensivos pediátricos com lesões vasculares cerebrais não traumáticas. Métodos: Estudo retrospetivo baseado nos processos clínicos de doentes internados numa unidade de cuidados intensivos pediátricos entre janeiro de 2007 e dezembro de 2013 com lesão vascular cerebral não traumática. Resultados: Incluíram-se 45 doentes, mediana da idade 8,2 anos, 70% do sexo masculino. Ocorreram 22 casos (49%) de acidente vascular cerebral hemorrágico, 15 de acidente vascular cerebral isquémico (33%) e oito de trombose venosa cerebral (18%). Necessitaram de intervenção neurocirúrgica 18 doentes e neurorradiológica cinco doentes. Um doente fez trombólise sistémica utilizando alteplase, 76% necessitaram de controlo médico da hipertensão intracraniana, 57% de ventilação mecâ-nica, 30% de suporte cardiovascular e 28% de terapêutica antiepilética. Ocorreram cinco óbitos (11%), quatro em doentes com acidente vascular cerebral hemorrágico. Utilizando a escala KOSCHI (King's Outcome Scale for Childhood Head Injury), atualmente 23 (51%) doentes são independentes, incluindo 17 que não apresentam qualquer sequela. Discussão: Registaram-se, em média, seis internamentos por ano por acidente vascular cerebral não traumático, sendo mais frequente o hemorrágico. A precocidade do diagnóstico e a referenciação atempada para centros especializados são cruciais para a melhoria do prognóstico. A abordagem multidisciplinar num centro com disponibilidade permanente de recursos humanos e materiais terá contribuído para a sobrevida e boa recuperação funcional verificada na maioria dos casos. Palavras-chave:Acidente Vascular Cerebral; Criança; Unidades de Cuidados Intensivos Pediátricos; Trombose Venosa Abstract Introduction: Vascular brain lesions, including haemorrhagic stroke, ischaemic stroke and cerebral venous thrombosis, are important causes of morbidity and mortality. Paediatric studies regarding the best therapeutic approach are scarce. The aim of this study was to describe the therapeutic approach and neurological outcome in patients admitted to a paediatric intensive care unit with non-traumatic vascular brain lesions. Methods: A retrospective analysis was conducted using medical records of patients with non-traumatic vascular brain lesions admitted to a paediatric intensive care unit between January 2007 and December 2013. Results: Forty-five patients were included, 70% male, median age 8.2 years. There were 22 cases (49%) of haemorrhagic stroke, 15 (33%) of ischaemic stroke and

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Risk of stroke in children

Abstract: Rates of hospitalization for stroke are higher among black children and boys; sickle cell disease and trauma do not fully account for these findings.

Cited by 506 publications

References 39 publications

Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign

Ischemic Stroke in Children with Critical Illness: A Poor Prognostic Sign

Patients with sickle cell disease are frequently excluded from the benefits of transcranial doppler screening for the risk of stroke despite extensive and compelling evidence

Acidentes Vasculares Cerebrais em Idade Pediátrica: O Papel dos Cuidados Intensivos

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