Childhood arterial ischemic stroke in Egypt

Nabil Kitchener, Magdy Khalaf, Gamal Khairalla, Mohammed Helmy
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Abstract

Arterial ischemic stroke (AIS) in neonates and children is a major cause of significant morbidity and mortality.1–4 Although considered rare, estimates place the incidence of AIS at 2.7 per 100 000 children, which is comparable to the incidence of brain tumors in children.5 Unlike brain tumors however, there is no comprehensive, multi-institutional approach to understand the pathophysiology and improve the management of childhood AIS. Our understanding of the epidemiology of childhood AIS in Egypt is limited. Judging by the largest cohort of childhood stroke available, the majority of children with AIS presented in association with a recognized risk factor.6 However, over one third of cases occur in otherwise well children.6 Recent interests have focused on thrombophilia as a cause of AIS in these children.7 Thrombophilic states may lead to a reduced threshold for pathological thrombus formation in cerebral vessels presenting with AIS in children.8 An association between thrombophilia and AIS may warrant development of primary and secondary thromboprophylactic strategies as prevention of childhood AIS. To gain a greater understanding of epidemiology, risk factors including thrombophilic abnormalities, and outcome of childhood AIS in Egypt, we reviewed all cases of AIS admitted to the EL Mataryia Teaching Hospital, Cairo, Egypt 2004–2008.
埃及儿童动脉缺血性中风
动脉缺血性脑卒中(AIS)是新生儿和儿童发病率和死亡率的主要原因。1-4虽然被认为是罕见的,但估计AIS的发病率为每10万名儿童2.7例,与儿童脑肿瘤的发病率相当然而,与脑肿瘤不同的是,目前还没有全面的、多机构的方法来了解儿童AIS的病理生理学并改善其管理。我们对埃及儿童AIS流行病学的了解有限。根据目前最大的儿童卒中队列研究,大多数AIS患儿的表现与一个公认的危险因素有关然而,超过三分之一的病例发生在其他方面健康的儿童身上最近的兴趣集中在血栓形成是这些儿童AIS的一个原因嗜血栓状态可能导致儿童AIS患者脑血管病理性血栓形成阈值降低血栓病和AIS之间的联系可能需要开发初级和次级血栓预防策略来预防儿童AIS。为了更好地了解埃及儿童AIS的流行病学、危险因素(包括血栓性异常)和预后,我们回顾了2004-2008年埃及开罗EL Mataryia教学医院收治的所有AIS病例。
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