Pavlakis S G, Gould R J, Zito J L
Cornell University Medical College, Department of Neurology, New York, New York.
Adv Pediatr. 1991;38:151-79.
Childhood stroke, although similar to adult stroke, is characterized by congenital and genetic causes. The evaluation and treatment of the child with stroke requires special considerations. Currently, drug therapy is untested and as a result, therapeutic interventions are problematic. Platelet antagonists are rational prophylactically; warfarin probably has a role in preventing cardiogenic embolus in the older child. However, chronic anticoagulation in the toddler is dangerous due to frequent trauma and is therefore relatively contraindicated. Vascular malformations are surgically repaired but alternative therapies, including radiation and embolization, may be used for inoperable lesions. Aneurysms are primarily surgical lesions. Newer imaging modalities will clarify the pathophysiologic picture and improve treatment.
儿童中风虽然与成人中风相似，但其特征是由先天性和遗传原因引起的。对中风儿童的评估和治疗需要特殊考虑。目前，药物治疗尚未经过测试，因此治疗干预存在问题。预防性使用血小板拮抗剂是合理的；华法林可能在预防大龄儿童的心源性栓塞方面有作用。然而，幼儿长期抗凝由于频繁受伤而危险，因此相对禁忌。血管畸形可通过手术修复，但对于无法手术的病变，可使用包括放疗和栓塞在内的替代疗法。动脉瘤主要通过手术治疗。更新的成像方式将阐明病理生理情况并改善治疗。
