Gerstl L, Bonfert M V, Nicolai T, Dieterich M, Adamczyk C, Heinen F, Olivieri M, Steinlin M
Pädiatrische Neurologie und Entwicklungsneurologie LMU Zentrum - iSPZ Hauner, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital der Universität München, Lindwurmstr. 4, 80337, München, Deutschland.
Abteilung für Spezielle Pädiatrische Intensivmedizin und Notfallmedizin, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital der Universität München, München, Deutschland.
Nervenarzt. 2017 Dec;88(12):1367-1376. doi: 10.1007/s00115-017-0435-7.
Childhood arterial ischemic stroke differs in essential aspects from adult stroke. It is rare, often relatively unknown among laypersons and physicians and the wide variety of age-specific differential diagnoses (stroke mimics) as well as less established care structures often lead to a considerable delay in the diagnosis of stroke. The possible treatment options in childhood are mostly off-label. Experiences in well-established acute treatment modalities in adult stroke, such as thrombolysis and mechanical thrombectomy are therefore limited in children and only based on case reports and case series. The etiological clarification is time-consuming due to the multitude of risk factors which must be considered. Identifying each child's individual risk profile is mandatory for acute treatment and secondary prevention strategies and has an influence on the individual outcome. In addition to the clinical neurological outcome the residual neurological effects of stroke on cognition and behavior are decisive for the integration of the child into its educational, later professional and social environment.
儿童动脉缺血性卒中在本质方面与成人卒中不同。它很罕见，在非专业人士和医生中通常相对不为人知，而且各种各样的年龄特异性鉴别诊断（类卒中）以及不太完善的护理结构常常导致卒中诊断出现相当大的延迟。儿童期可能的治疗选择大多属于超说明书用药。因此，成人卒中中成熟的急性治疗方式，如溶栓和机械取栓，在儿童中的经验有限，仅基于病例报告和病例系列。由于必须考虑众多风险因素，病因学的明确很耗时。确定每个儿童的个体风险状况对于急性治疗和二级预防策略至关重要，并且会影响个体预后。除了临床神经学预后外，卒中对认知和行为的残留神经学影响对于儿童融入其教育、日后职业和社会环境具有决定性作用。
