Department of Pediatrics, Beijing Tiantan Hosppital Affiliated to Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Disease, Beijing, China.
Stroke Vasc Neurol. 2022 Apr;7(2):140-148. doi: 10.1136/svn-2021-001062. Epub 2021 Dec 3.
To investigate clinical characteristics, risk factors (RFs), neurologic deficits and medical care provided in children who had a stroke in China.
We conducted a retrospective case-series study using the medical records of children aged 1 month to 18 years with arterial ischaemic stroke (AIS) or haemorrhagic stroke (HS) (with the entry codes I60, I61, I62, I63 (ICD-10)), who were admitted to different hospitals in Beijing, between January 2018 and December 2018. We obtained the following information from the charts: demographic characteristics, clinical presentations, RFs for paediatric stroke, laboratory examination, neuroimaging records and neurologic sequelae.
We identified 312 first admissions for stroke (172 AIS and 140 HS). The mean age at onset was 8.6±3.9 years for patients who had an AIS and 8 (5-13) years for patients who had an HS. There were more males than females in both groups (AIS: 59.88% vs 40.12%; HS: 52.14% vs 47.86%). A known aetiology was identified in 92.44% and 86.43% of patients who had an AIS and HS, respectively. The leading cause of AIS was cerebrovascular diseases including moyamoya (68.6%), while that for HS was arteriovenous malformation (51.43%). The most common initial clinical presentation was hemiplegia (86.05%) in patients who had an AIS and headache (67.86%) in patients who had an HS. The use of healthcare, including acute treatment (antithrombotic in 17.44%, anticoagulant in 5.23%) and secondary prevention (antithrombotic in 6.39%, anticoagulant in 1.16%), varied and was significantly lower among patients who had an AIS. The most common complications were epilepsy (22.09%) and pneumonia (4.65%) in patients who had an AIS and epilepsy (17.14%) and hydrocephalus (12.14%) in patients who had an HS. Neurological deficits occurred in 62.8% of patients who had an AIS and 72.86% of patients who had an HS.
Cerebral arteriopathy was a major RF for both AIS and HS in children living in China. Large epidemiological studies are required to identify RFs to prevent stroke as well as appropriate interventions.
研究中国儿童卒中的临床特征、危险因素（RFs）、神经功能缺损和医疗护理情况。
我们对 2018 年 1 月至 12 月期间在北京不同医院就诊的年龄在 1 个月至 18 岁的动脉缺血性卒中（AIS）或出血性卒中（HS）患儿（ICD-10 编码 I60、I61、I62、I63）的病历进行了回顾性病例系列研究。我们从图表中获得了以下信息：人口统计学特征、临床表现、儿科卒中的 RFs、实验室检查、神经影像学记录和神经后遗症。
我们共发现 312 例首次卒中住院患者（172 例 AIS 和 140 例 HS）。AIS 患儿的发病年龄平均为 8.6±3.9 岁，HS 患儿为 8（5-13）岁。两组中男性均多于女性（AIS：59.88% vs 40.12%；HS：52.14% vs 47.86%）。AIS 和 HS 患儿中分别有 92.44%和 86.43%的患儿确定了病因。AIS 的主要病因是脑血管疾病，包括烟雾病（68.6%），HS 的主要病因是动静脉畸形（51.43%）。AIS 患儿最常见的初始临床表现为偏瘫（86.05%），HS 患儿为头痛（67.86%）。医疗保健的使用情况各不相同，包括急性治疗（抗血栓治疗 17.44%，抗凝治疗 5.23%）和二级预防（抗血栓治疗 6.39%，抗凝治疗 1.16%），且 AIS 患儿的使用情况明显低于 HS 患儿。AIS 患儿最常见的并发症是癫痫（22.09%）和肺炎（4.65%），HS 患儿则是癫痫（17.14%）和脑积水（12.14%）。AIS 患儿中有 62.8%存在神经功能缺损，HS 患儿中有 72.86%存在神经功能缺损。
在中国，儿童的 AIS 和 HS 的主要 RF 是脑动脉病变。需要进行大规模的流行病学研究，以确定 RF 以预防卒中，并采取适当的干预措施。
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