{"title":"儿童急性动脉缺血性卒中:单中心经验。","authors":"Muharrem Bostancı, Arzu Ekici, Cengiz Havalı","doi":"10.1055/s-0045-1809661","DOIUrl":null,"url":null,"abstract":"<p><p>Arterial ischemic stroke (AIS) is an increasingly common disorder in childhood that causes severe mortality and morbidity.To emphasize the importance of early diagnosis and treatment of AIS cases, as well as the early initiation of physical therapy.We retrospectively reviewed the medical records of 23 patients aged 1 month to 18 years, who were admitted with acute neurological complaints and diagnosed radiologically with AIS at the Bursa Yüksek İhtisas Training and Research Hospital, a tertiary healthcare facility, between January 2016 and June 2020.Neurological deficit was the most common (12 patients; 52%) complaint, followed by seizure in 5 patients (21%), facial paralysis in 5 patients (21%), and visual impairment in 3 patients (13%). We performed brain computed tomography (CT) scans in 12 (52%) patients at the first application, and infarction was detected in 8 (66%). Infarction was in the cerebrum in 19 (82%) patients. Mutations of the <i>methylenetetrahydrofolate reductase</i> (<i>MTHFR</i>; A1298C and 677C > T) gene were found most frequently. Cardiac anomalies were detected in 7 (30%) patients, and 2 patients had ventriculoperitoneal shunts.Arterial ischemic stroke presents very different clinical findings, such as hiccups, anisocoria, and upward gaze paralysis. We wanted to emphasize the importance of cranial CT scanning because sometimes MRI is not always easily performed in children. 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引用次数: 0
摘要
动脉缺血性脑卒中(AIS)是一种日益常见的儿童疾病,可导致严重的死亡率和发病率。强调早期诊断和治疗AIS病例的重要性,以及早期开始物理治疗。我们回顾性地回顾了2016年1月至2020年6月期间,在三级医疗机构Bursa y ksek İhtisas培训和研究医院因急性神经系统疾病和放射诊断为AIS的23例患者的医疗记录,年龄在1个月至18岁之间。神经功能缺损最为常见(12例;52%),其次是癫痫发作5例(21%),面瘫5例(21%),视力障碍3例(13%)。我们在首次应用时对12例(52%)患者进行了脑部计算机断层扫描(CT),其中8例(66%)检测到梗死。19例(82%)患者发生脑梗死。亚甲基四氢叶酸还原酶(MTHFR)突变A1298C和677C >t)基因最常见。7例(30%)患者发现心脏异常,2例有脑室-腹膜分流。动脉缺血性中风表现出非常不同的临床表现,如呃逆、斜视和向上凝视瘫痪。我们想强调颅脑CT扫描的重要性,因为有时在儿童中进行MRI并不总是容易的。伴随的情况,如颅内手术、脑室-腹膜分流术和软骨发育不全,都可能增加中风的风险。
Acute arterial ischemic stroke in children: single-center experience.
Arterial ischemic stroke (AIS) is an increasingly common disorder in childhood that causes severe mortality and morbidity.To emphasize the importance of early diagnosis and treatment of AIS cases, as well as the early initiation of physical therapy.We retrospectively reviewed the medical records of 23 patients aged 1 month to 18 years, who were admitted with acute neurological complaints and diagnosed radiologically with AIS at the Bursa Yüksek İhtisas Training and Research Hospital, a tertiary healthcare facility, between January 2016 and June 2020.Neurological deficit was the most common (12 patients; 52%) complaint, followed by seizure in 5 patients (21%), facial paralysis in 5 patients (21%), and visual impairment in 3 patients (13%). We performed brain computed tomography (CT) scans in 12 (52%) patients at the first application, and infarction was detected in 8 (66%). Infarction was in the cerebrum in 19 (82%) patients. Mutations of the methylenetetrahydrofolate reductase (MTHFR; A1298C and 677C > T) gene were found most frequently. Cardiac anomalies were detected in 7 (30%) patients, and 2 patients had ventriculoperitoneal shunts.Arterial ischemic stroke presents very different clinical findings, such as hiccups, anisocoria, and upward gaze paralysis. We wanted to emphasize the importance of cranial CT scanning because sometimes MRI is not always easily performed in children. Concomitant conditions, such as intracranial operation, ventriculoperitoneal shunt, and hypochondroplasia, may increase the risk of stroke.
期刊介绍:
Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology.
The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.