Sarecka-Hujar Beata, Kopyta Ilona
Department of Pharmaceutical Technology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland.
Department of Paediatric Neurology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.
Brain Sci. 2020 Jan 2;10(1):24. doi: 10.3390/brainsci10010024.
Arterial ischemic stroke (AIS) experienced at a young age is undoubtedly a serious medical problem. AIS very rarely occurs at a developmental age, whereas in young adults, it occurs with a higher frequency. The etiologic mechanisms of AIS occurring in childhood and adulthood differ. However, for both age populations, neurological consequences of AIS, including post-stroke seizures, motor disability, and recurrence of the disease, are connected to many years of care, rehabilitation, and treatment. Recurrent stroke was observed to increase the risk of patients' mortality. One of the confirmed risk factors for recurrent stroke in children is the presence of vasculopathies, especially Moyamoya disease and syndrome, and focal cerebral arteriopathy of childhood (FCA). FCA causes a 5-fold increase in the risk of recurrent stroke in comparison with idiopathic AIS. In turn, young adults with recurrent stroke were found to more often suffer from hypertension, diabetes mellitus, or peripheral artery disease than young patients with first-ever stroke. Some reports also indicate relationships between specific genetic polymorphisms and AIS recurrence in both age groups. The aim of the present literature review was to discuss available data regarding the risk factors for recurrent AIS in children and young adults.
年轻时发生的动脉缺血性卒中(AIS)无疑是一个严重的医学问题。AIS在发育年龄极少发生,而在年轻人中发生频率较高。儿童期和成年期发生AIS的病因机制不同。然而,对于这两个年龄段的人群,AIS的神经学后果,包括卒中后癫痫发作、运动功能障碍和疾病复发,都与多年的护理、康复和治疗相关。观察到复发性卒中会增加患者的死亡风险。儿童复发性卒中已确认的风险因素之一是存在血管病变,尤其是烟雾病和烟雾综合征,以及儿童局灶性脑动脉病(FCA)。与特发性AIS相比,FCA会使复发性卒中的风险增加5倍。反过来,与首次发生卒中的年轻患者相比,复发性卒中的年轻成年人更常患有高血压、糖尿病或外周动脉疾病。一些报告还指出了特定基因多态性与这两个年龄组AIS复发之间的关系。本文献综述的目的是讨论关于儿童和年轻成年人复发性AIS风险因素的现有数据。