Division of Pediatric Neurology, Department of Neurology, Johns Hopkins University School of Medicine, Suite 2158, 200 North Wolfe Street, Baltimore, MD 21287, USA.
Nat Rev Neurol. 2011 Apr;7(4):199-208. doi: 10.1038/nrneurol.2011.23. Epub 2011 Mar 8.
Stroke in children is rarely due to traditional stroke risk factors such as hypertension and diabetes. Rather, stroke in this patient group typically results from the simultaneous occurrence of multiple stroke risk factors, the presence of which necessitates a thorough evaluation to determine the cause of this disorder. Several challenges exist in the care of children with stroke. Of note, recognition of pediatric stroke onset by parents and caregivers is often delayed, highlighting the need for increased awareness of and education regarding this condition. Moreover, various neurological conditions resemble stroke in pediatric patients and a definite diagnosis of this disorder requires MRI; adding to the diagnostic challenge, young children may need to be sedated to undergo acute MRI. Perhaps the most significant challenge is the need for clinical research studies focusing on pediatric stroke treatment, so as to allow evidence-based treatment decision-making. A final challenge is the standardization of outcome assessment after stroke for a wide range of ages and developmental levels. In this Review, we examine recent findings and diagnostic issues pertaining to both arterial ischemic stroke and hemorrhagic stroke in children.
儿童中风很少是由于高血压和糖尿病等传统中风危险因素引起的。相反，该患者群体中的中风通常是由多种中风危险因素同时发生引起的，这需要进行彻底的评估以确定该疾病的原因。患有中风的儿童的护理存在一些挑战。值得注意的是，父母和照顾者通常会延迟识别儿童中风发作，这突出表明需要提高对此病症的认识和教育。此外，各种神经疾病在儿科患者中类似于中风，并且需要 MRI 来明确诊断这种疾病；由于幼儿可能需要镇静才能进行急性 MRI，这增加了诊断上的挑战。也许最大的挑战是需要开展侧重于儿童中风治疗的临床研究，从而能够基于证据做出治疗决策。最后一个挑战是对广泛的年龄和发育水平的中风后结果评估进行标准化。在这篇综述中，我们检查了与儿童动脉缺血性中风和出血性中风相关的最新发现和诊断问题。
