Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee.
Department of Neurology, Medical College of Wisconsin, Milwaukee; Department of Medicine, Medical College of Wisconsin, Milwaukee.
J Stroke Cerebrovasc Dis. 2010 May;19(3):175-183. doi: 10.1016/j.jstrokecerebrovasdis.2009.03.013.
Pediatric stroke is among the top 10 causes of death in children and an important cause of chronic morbidity, with an incidence of 3.3/100,000 children/year. Risk factors associated with stroke in children include cardiac diseases, hematologic and vascular disorders, and infection. Clinical presentation varies depending on age, underlying cause, and stroke location. Antithrombotics and anticoagulants are used in the treatment of pediatric stroke; however, there are no established guidelines for the use of these agents in children. In this article we review the cause, pathophysiology, clinical presentation, diagnosis, acute management, secondary prevention, and outcome of children with stroke. The approach to patients with sickle cell disease and Moyamoya disease is also discussed. Up to date studies to determine the optimal acute treatment of childhood stroke and secondary prevention and risk factor modification are critically needed.
儿科脑卒中是儿童死亡的十大原因之一，也是导致慢性残疾的重要原因，其发病率为每 10 万儿童 3.3 例。与儿童脑卒中相关的危险因素包括心脏疾病、血液系统和血管疾病以及感染。临床表现取决于年龄、潜在病因和脑卒中部位。抗血栓和抗凝药物用于治疗儿科脑卒中；然而，目前尚无这些药物在儿童中使用的既定指南。本文综述了儿童脑卒中的病因、病理生理学、临床表现、诊断、急性期管理、二级预防和结局。文中还讨论了镰状细胞病和烟雾病患儿的处理方法。目前迫切需要开展研究以确定儿童脑卒中急性期治疗的最佳方案，以及二级预防和危险因素的处理。
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