Evaluation of Cerebrovascular Events Followed in Pediatric Intensive Care Unit.

Ulkem Kocoglu Barlas, Nihal Akcay, Mehmet Emin Menentoglu, Figen Bakirtas Palabiyik, Esra Sevketoglu
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Abstract

Aim: To evaluate the effect of intensive care follow-up and treatment methods on the prognosis of 28 patients admitted to the pediatric intensive care unit (PICU) due to stroke.

Material and methods: The data of patients aged between 28 days and 18 years followed up between 2011 and 2021 were recorded retrospectively.

Results: Thirteen (48.1%) patients were diagnosed with hemorrhagic stroke (HS), 11 (40.7%) patients were diagnosed with acute ischemic stroke (AIS), and three (11.1%) patients were diagnosed with cerebral sinus vein thrombosis. One patient was followed up for non-ruptured arteriovenous malformation (AVM) and was excluded from the HS group. The HS group consisted of eight patients with ruptured AVMs and five patients with ruptured intracranial aneurysms. The patients had male predominance, and seizures and headache were the most common complaints on admission. The rate of admissions due to seizures was higher in the AIS group. In the HS group, there was more involvement of the right side of the brain. Middle cerebral artery (MCA) involvement was higher in the AIS group. The AIS group had longer PICU hospitalization days and mechanical ventilator days. While unfractionated heparin was preferred for the treatment in the AIS group, endovascular embolization was preferred in the HS group. Decompressive surgery was performed in five patients. The overall mortality rate was 7.1%.

Conclusion: Although cerebrovascular events are rare in the pediatric population, achieving low mortality and morbidity is possible with the correct diagnostic and treatment methods.

儿科重症监护病房脑血管事件的评估。
目的:脑卒中是指由脑血管事件(CVE)引起的急性神经功能缺损。在这项研究中,我们评估了重症监护随访和治疗方法对28名因中风入住儿科重症监护室(PICU)的患者预后的影响。材料和方法:回顾性记录2011年至2021年间随访的年龄在28天至18岁之间的患者的数据。结果:13例(48.1%)患者被诊断为出血性脑卒中(HS),11例(40.7%)患者被确诊为急性缺血性脑卒中(AIS),3例(11.1%)被诊断为脑窦静脉血栓形成。一名患者因未破裂的动静脉畸形(AVM)进行了随访,并被排除在HS组之外。HS组包括8名AVM破裂患者和5名颅内动脉瘤破裂患者。患者以男性为主,入院时最常见的主诉是癫痫发作和头痛。AIS组因癫痫发作入院的比率较高。在HS组中,右侧大脑的受累更多。AIS组的大脑中动脉(MCA)受累率较高。AIS组的PICU住院天数和机械通气天数较长。AIS组首选普通肝素治疗,HS组首选血管内栓塞治疗。对5名患者进行了减压手术。总死亡率为7.1%。结论:尽管CVE在儿科人群中很少见,但通过正确的诊断和治疗方法,实现低死亡率和低发病率是可能的。
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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