Spinal Cord Stroke in the Pediatric Population: A Clinical Overview

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-06-12 DOI:10.1016/j.pediatrneurol.2025.06.002

Amr Elgehiny MD , Matthew Wright MD , Lakshmi Srivaths MD , Sishir Mannava MD , Shaikha AlQahtani MD , Jiasen He MD , Daniel Davila-Williams MD , Stuart Fraser MD

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Abstract

Background

Spinal cord stroke is a rare but serious condition in the pediatric population, with limited data available. We present a series of 6 pediatric cases to review their clinical presentation, magnetic resonance imaging (MRI) findings, etiology, risk factors, management, and outcomes.

Methods

A descriptive analysis was conducted following institutional review board approval, focusing on 6 pediatric patients previously identified by the authors.

Results

The median age at presentation was 10 years, with diverse clinical presentations including back, neck, or shoulder pain and hemiplegia; one patient presented with quadriplegia. MRI findings demonstrated distinct infarction patterns, and thrombophilia evaluations were negative in all cases. Treatment was primarily supportive. Four patients received prophylactic aspirin. Follow-up revealed that 3 patients were ambulatory, whereas 3 exhibited persistent motor deficits, and 2 had a neurogenic bladder.

Conclusion

Spinal stroke in children is rare and often idiopathic, with fibrocartilaginous embolism frequently suggested but rarely confirmed. MRI was crucial for diagnosis, and thrombophilia evaluation is usually recommended in pediatric stroke, including spinal stroke, although no thrombophilia cases were found. Treatment was supportive, with steroids used for suspected inflammation and prophylactic aspirin administered in some cases. Long-term outcomes varied, with some patients experiencing substantial recovery and others showing persistent deficits, highlighting the importance of individualized rehabilitation.

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脊髓卒中在儿科人群：临床综述

背景：脊髓性中风是儿科人群中一种罕见但严重的疾病，可获得的数据有限。我们报告了6例儿科病例，回顾他们的临床表现，磁共振成像（MRI）结果，病因，危险因素，管理和结果。方法在机构审查委员会批准后，对作者先前确定的6例儿科患者进行描述性分析。结果患者就诊时的中位年龄为10岁，临床表现多样，包括背部、颈部或肩部疼痛和偏瘫；1例患者出现四肢瘫痪。MRI结果显示明显的梗死模式，所有病例的血栓形成评估均为阴性。治疗主要是支持性的。四名患者服用了预防性阿司匹林。随访显示，3例患者可走动，3例表现出持续性运动障碍，2例有神经源性膀胱。结论小儿脊髓卒中少见，多为特发性，纤维软骨栓塞常被提示，但很少被证实。MRI对诊断至关重要，尽管没有发现血栓形成病例，但通常建议对儿童中风（包括脊髓卒中）进行血栓形成评估。治疗是支持性的，对疑似炎症使用类固醇，在某些情况下使用预防性阿司匹林。长期结果各不相同，一些患者经历了实质性的恢复，而另一些患者则表现出持续的缺陷，这突出了个性化康复的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.