Pediatric Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Neurology, University of Illinois College of Medicine at Peoria and OSF Healthcare Illinois Neurological Institute, Peoria, Illinois.
J Clin Sleep Med. 2021 Aug 1;17(8):1743-1747. doi: 10.5664/jcsm.9390.
Obstructive sleep apnea is associated with an increased risk of acute ischemic cerebrovascular accidents in adults. However, this association has not been well established in the pediatric population. We report a case of acute right internal capsule lacunar infarct manifesting as left-sided hemiplegia in an adolescent with severe obesity. Severe untreated obstructive sleep apnea was identified during the hospital stay. Positive airway pressure therapy, weight loss, and tonsillectomy eventually normalized sleep-disordered breathing. The patient recovered completely without any residual neurological deficits with multidisciplinary care. Lacunar infarcts due to hypertension-related cerebral vasculopathy are a well-known cause of stroke in adults. Untreated obstructive sleep apnea may cause hypertension and potentially predispose even the pediatric population to develop lacunar infarcts. Polysomnography needs to be considered as a part of the diagnostic algorithm in pediatric patients with stroke.
Chen B, Gorantla S, Shah V. Acute lacunar infarct in an obese adolescent with obstructive sleep apnea. . 2021;17(8):1743-1747.
阻塞性睡眠呼吸暂停与成年人急性缺血性脑血管意外的风险增加有关。然而，这种关联在儿科人群中尚未得到很好的证实。我们报告了一例青少年严重肥胖患者，表现为左侧偏瘫的急性右侧内囊腔隙性梗死病例。在住院期间发现严重的未经治疗的阻塞性睡眠呼吸暂停。气道正压治疗、减肥和扁桃体切除术最终使睡眠呼吸障碍正常化。在多学科治疗下，患者完全康复，无任何遗留神经功能缺损。高血压相关脑小血管病变引起的腔隙性梗死是成人中风的一个已知原因。未经治疗的阻塞性睡眠呼吸暂停可能导致高血压，并可能使儿科人群易发生腔隙性梗死。在伴有中风的儿科患者中，需要考虑多导睡眠图作为诊断算法的一部分。
