Risk Factors and Neurologic Outcomes in Childhood Arterial Ischemic Stroke
Öz
Objective: The aim of this study is to describe clinical characteristics, treatment modalities and outcomes of children with arterial ischemic stroke (AIS).
Material and Methods: We retrospectively reviewed the charts of 102 children (62 girls and 40 boys) with AIS admitted at our hospital between 2009 and 2015. Age at stroke, sex, medical history, family history, clinical findings upon admission, history of seizure, and radiological findings were recorded. Cardiac assessment, hematological and immunological tests, metabolic screening were all performed in the patients.
Results: In 25 children stroke occured as a complication of cardiac disease, 12 had transient cerebral arteriopathy, 11 had Down’s syndrome, 9 had thalassemia, 7 had moyamoya disease, 6 had MTHFR mutation, 4 had homozygote for factor V Leiden, 3 had protein C deficiency, 1 had sickle cell disease, and in 24 children no underlying cause could be found. Multiple risk factors were found in 16 children and recurrent stroke was observed in 4 patients. Hemiplegia was the commonest initial clinical presentation (88.2%) followed by seizure (66.6%) and decreased level of consciousness (54.9%). The avarage length of follow-up was 32.1±5.4 months. The outcome in all 102 stroke patients was as follows: asymptomatic 57.8%; persistent neurologic deficit or epilepsy 40.2%; and death 2%.
Conclusion: Our study showed an underlying cause for AIS in 76.5% of the patients; 42.2% of the patients either died or had motor and/or cognitive sequelae and recurrence occured despite prophylactic aspirin treatment in 4 patients.
Anahtar Kelimeler
Kaynakça
- 1. Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, Ferriero D, Jones BV, Kirkham FJ, Scott RM, Smith ER.. A scientific statement from a special writing group of the American Heart Association Stroke Council and the Council of Cardiovascular Disease in the Young. Stroke. 2008;39: 2644-91.
- 2. de Veber G, Roach ES, Riela AR, Wiznitzer M. Stroke in children: recognition, treatment, and future directions. Semin Pediatr Neurol 2000;7:309-17.
- 3. Simma B, Martin G, Müller T, Huemer M. Risk factors for pediatric stroke: consequences for therapy and quality of life. Pediatr Neurol. 2007;37:121-6.
- 4. Touré A, Chabrier S, Plagne MD, Presles E, des Portes V, Rousselle C. Neurological outcome and risk of recurrence depending on the anterior vs.posterior arterial distribution in children with stroke. Neuropediatrics. 2009;40:126-8.
- 5. Westmacott R, Askalan R, MacGregor D, Anderson P, Deveber G. Cognitive outcome following unilateral arterial ischaemic stroke in childhood:effects of age at stroke and lesion location. Dev Med Child Neurol. 2010;52:386-93.
- 6. Incecik F, Ozlem Hergüner M, Altunbasak S. Risk factors and treatment outcomes for children with arterial ischemic stroke. J Clin Neurosci. 2010;17:1000-2.
- 7. Lopez-Vicente M, Ortega-Gutierrez S, Amlie-Lefond C, Torbey MT. Diagnosis and management of pediatric arterial ischemic stroke. J Stroke Cerebrovasc Dis. 2010;19:175-83.
- 8. M. Steinlin, I. Pfister, J. Pavlovic, Everts R, Boltshauser E, Capone Mori A, Gubser Mercati D, Hänggeli CA, Keller E. The first three years of the Swiss Neuropaediatric Stroke Registry (SNPSR): a population-based study of incidence, symptoms and risk factors. Neuropediatrics. 2005;36: 90–97.
Ayrıntılar
Birincil Dil
Türkçe
Konular
Sağlık Kurumları Yönetimi
Bölüm
Araştırma Makalesi
Yazarlar
Taner Sezer
Baskent University, School of Medicine, Department of Pediatric Neurology
Türkiye
Yayımlanma Tarihi
30 Eylül 2017
Gönderilme Tarihi
14 Mayıs 2017
Kabul Tarihi
19 Mayıs 2017
Yayımlandığı Sayı
Yıl 2017 Cilt: 7 Sayı: 3