Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Departments of Neurology and Pediatrics, Weill Institute of Neurosciences, University of California at San Francisco, San Francisco, CA, USA.
Lancet Child Adolesc Health. 2021 Nov;5(11):825-836. doi: 10.1016/S2352-4642(21)00167-X. Epub 2021 Jul 29.
Paediatric arterial ischaemic stroke is an important cause of neurological morbidity in children, with consequences including motor disorders, intellectual impairment, and epilepsy. The causes of paediatric arterial ischaemic stroke are unique compared with those associated with stroke in adulthood. The past decade has seen substantial advances in paediatric stroke research and clinical care, but many unanswered questions and controversies remain. Shortage of prospective evidence for the use of recanalisation therapies in patients with paediatric stroke has resulted in little standardisation of disease management. Substantial time delays in diagnosis and treatment continue to challenge best possible care. In this Review, we highlight on some of the most pressing and productive aspects of research in the treatment of arterial ischaemic stroke in children, including epidemiology and cause, rehabilitation, secondary stroke prevention, and treatment updates focusing on advances in hyperacute therapies such as intravenous thrombolysis, mechanical thrombectomy, and critical care. Finally, we provide a future perspective for improving outcomes and quality of life for affected children and their families.
儿科动脉缺血性脑卒中是儿童神经系统疾病的重要原因，其后果包括运动障碍、智力障碍和癫痫。与成人中风相关的原因相比，儿科动脉缺血性脑卒中的病因具有独特性。过去十年，儿科中风研究和临床护理取得了重大进展，但仍有许多未解决的问题和争议。由于缺乏前瞻性证据来支持使用再通疗法治疗儿科中风患者，因此疾病管理几乎没有标准化。诊断和治疗方面的大量时间延迟仍然是挑战最佳治疗效果的因素。在这篇综述中，我们重点介绍了儿科动脉缺血性脑卒中治疗研究中一些最紧迫和最有成效的方面，包括流行病学和病因、康复、二级中风预防以及重点介绍超急性治疗进展的治疗更新，如静脉溶栓、机械取栓和重症监护。最后，我们为改善受影响儿童及其家庭的预后和生活质量提供了未来展望。
