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儿童动脉缺血性卒中(AIS):来自单一控制中心的临床报告。

Arterial ischemic stroke (AIS) in childhood: clinical report from a single control center.

作者信息

Portale Anna, Fiumara Agata, Scalora Luisa, Greco Filippo, Smilari Pierluigi, Venti Valeria, Pustorino Elena, Pavone Piero

机构信息

Department of Pediatrics, AOU Policlinico-Vittorio Emanuele, University of Catania, via S. Sofia 78, 95123, Catania, Italy.

出版信息

Childs Nerv Syst. 2019 Feb;35(2):283-293. doi: 10.1007/s00381-018-4017-1. Epub 2018 Dec 12.

Abstract

INTRODUCTION

Stroke is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. It is the third cause of death in adults and one of the top 10 causes in pediatric age. The perinatal period of onset is the second only to adult age group in the incidence of stroke. Arterial ischemic stroke during childhood occurs most frequently in the perinatal period with an incidence of 1 out 2300-5000 live infant births.

MATERIALS AND METHODS

This is a retrospective study that includes 28 patients affected by perinatal arterial ischemic stroke. Family and gestational history, risk factors of perinatal stroke, gender and clinical data of affected children and outcome are reported.

RESULTS

A stroke family history was registered in three unrelated families. Gestational history disclosed cases of threats of abortion, preterm delivery, hyperthermia, gestosis, and placental disorders. In the children, onset of seizures were reported within 3 days of life and diagnosis of stroke was confirmed by brain MRI which disclosed involvement of the middle cerebral artery in all the cases. Hemilateral cerebral palsy, epileptic seizures, and intellectual disability from mild to severe were the most frequent complications.

CONCLUSION

Stroke is still a common and dreadful events in perinatal period as this disorder is often unpredictable and cause of severe neurological impairment.

摘要

引言

中风是指由于全部或部分大脑血液供应中断而导致脑功能迅速丧失的临床病症。它是成年人死亡的第三大原因,也是儿童期十大死因之一。围生期发病在中风发病率方面仅次于成人年龄组。儿童期动脉缺血性中风最常发生在围生期,发病率为每2300 - 5000例活产婴儿中有1例。

材料与方法

这是一项回顾性研究,纳入了28例围生期动脉缺血性中风患儿。报告了患儿的家族史、妊娠史、围生期中风的危险因素、性别、临床资料及预后情况。

结果

在三个无血缘关系的家庭中发现有中风家族史。妊娠史显示存在流产威胁、早产、体温过高、妊娠中毒症及胎盘疾病等情况。患儿在出生后3天内出现惊厥发作,脑部MRI确诊为中风,所有病例均显示大脑中动脉受累。最常见的并发症是偏瘫型脑瘫、癫痫发作以及程度不一的智力残疾,从轻度到重度都有。

结论

中风在围生期仍然是常见且可怕的事件,因为这种病症往往不可预测,且会导致严重的神经功能损害。

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