A single-site retrospective study of pediatric arterial ischemic stroke etiology, clinical presentation, and radiologic features  

作　　者：SUN Dan WU Xiao-man WANG Zeng-wu JIN Run-ming LIU Zhi-sheng LIU Fan HUANG Sui WANG Hai-qin HU Jia-sheng 

机构地区：[1]Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China [2]Department of Neurology, Wuhan Children's Hospital, Wuhan, Hubei 430016, China [3]Department of Pediatrics, Fourth Hospital, Wuhan, Hubei 430016, China [4]Department of Neurosurgery, People's Hospital, Weifang, Shandong 261500, China

出　　处：《Chinese Medical Journal》2013年第18期3446-3450,共5页中华医学杂志（英文版）

摘　　要：Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been rarely reported. This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke （PALS）. Methods The medical records of 42 PAlS patients （age range： 9 months to 13 years） treated at Wuhan Children＇s Hospital between July 2007 and January 2011 were retrospectively reviewed. Infarction location was first determined by craniocerebral computed tomography and magnetic resonance （MR） imaging. The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography. Results The majority of the 42 PAlS cases （66.7%, n=28） were 〈3 years old （vs. 〉3 years old： 33.3%, n=14; P〈0.05）, but the male： female ratio was similar in both groups （P〉0.05）. The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium, but convulsions were more prevalent in children 〈3 years-old. Children〉3 years-old mainly experienced the limited physical activity symptoms, including hemiparalysis, aphasia, and ataxia. For all 42 cases, the most frequent etiologies were infections （38.1%, n=16）, iron deficiency anemia （16.7%, n=7）, and moyamoya syndrome （11.9%, n=5）. The predominant infarcts among all cases were middle cerebral artery （63.6%, n=21） and basal ganglia （64.3%, n=27）. Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms, but more research is required.Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been rarely reported. This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke （PALS）. Methods The medical records of 42 PAlS patients （age range： 9 months to 13 years） treated at Wuhan Children＇s Hospital between July 2007 and January 2011 were retrospectively reviewed. Infarction location was first determined by craniocerebral computed tomography and magnetic resonance （MR） imaging. The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography. Results The majority of the 42 PAlS cases （66.7%, n=28） were 〈3 years old （vs. 〉3 years old： 33.3%, n=14; P〈0.05）, but the male： female ratio was similar in both groups （P〉0.05）. The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium, but convulsions were more prevalent in children 〈3 years-old. Children〉3 years-old mainly experienced the limited physical activity symptoms, including hemiparalysis, aphasia, and ataxia. For all 42 cases, the most frequent etiologies were infections （38.1%, n=16）, iron deficiency anemia （16.7%, n=7）, and moyamoya syndrome （11.9%, n=5）. The predominant infarcts among all cases were middle cerebral artery （63.6%, n=21） and basal ganglia （64.3%, n=27）. Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms, but more research is required.

关 键 词：PEDIATRIC arterial ischemic stroke ETIOLOGY NEUROIMAGING diagnostic features 

分 类 号：Q66[生物学—生物物理学] S854.4[农业科学—临床兽医学]