Lynch John K, Han Christina J
Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892-1447, USA.
Semin Neurol. 2005 Dec;25(4):410-23. doi: 10.1055/s-2005-923535.
Stroke is a heterogeneous disorder and an important cause of mortality and chronic morbidity in children. Estimates of international incidence rates for childhood stroke have varied widely. Arterial ischemic stroke is reported to be more common than hemorrhagic stroke in children. The clinical presentation of stroke in children differs according to the child's age and stroke type and location. Several risk factors for ischemic and hemorrhagic stroke in children have been reported and include cardiac disorders, blood disorders, vasculopathies, viral infections, and arteriovenous malformations. Current treatment recommendations for stroke in children are based on small nonrandomized trials, adult stroke studies, case series, or consensus or individual expert opinion. Over half of children with stroke will develop lifelong cognitive or motor disability, and up to a third will have a recurrent stroke. International studies have provided important information on stroke in children, but major gaps in our knowledge of the disorder still exist. Currently, there is a need for prospective cohort studies in diverse populations, which utilize a consensus pediatric stroke classification system and a standard evaluation of risk factors and outcome, so that treatment and prevention strategies can be developed.
中风是一种异质性疾病，是儿童死亡和慢性发病的重要原因。儿童期中风的国际发病率估计差异很大。据报道，动脉缺血性中风在儿童中比出血性中风更常见。儿童中风的临床表现因儿童年龄、中风类型和部位而异。已报道儿童缺血性和出血性中风的几个危险因素，包括心脏疾病、血液疾病、血管病变、病毒感染和动静脉畸形。目前关于儿童中风的治疗建议基于小型非随机试验、成人中风研究、病例系列或共识或个人专家意见。超过一半的中风儿童会出现终身认知或运动残疾，高达三分之一的儿童会再次中风。国际研究提供了关于儿童中风的重要信息，但我们对该疾病的认识仍存在重大差距。目前，需要在不同人群中进行前瞻性队列研究，采用共识性儿童中风分类系统以及对危险因素和结局的标准评估，以便制定治疗和预防策略。
