Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain; Grupo de Investigación en Neurociencias, Instituto de Investigación Sanitaria (IIS) Aragón, Aragón, Spain.
Servicio de Pediatría, Hospital Materno Infantil - Hospital Universitario Miguel Servet, Zaragoza, Spain.
Neurologia (Engl Ed). 2024 Jul-Aug;39(6):474-485. doi: 10.1016/j.nrleng.2021.10.004. Epub 2022 Jun 9.
Recent years have seen considerable changes in the prevention and treatment of acute ischaemic stroke in adult patients. However, the low incidence of paediatric stroke makes the development of specific guidelines more challenging. This study aims to clarify the situation of these children in our region in order to establish a regional protocol to improve the care provided to these patients.
We performed a regional incidence study of pediatric stroke (≤ 15 years of age) in Aragon, Spain (1308728 population, 15% aged ≤ 15 years) between 2008 and 2019. Data were obtained from hospital discharge records, including deaths, from the regional health service of Aragón, according to ICD codes for cerebrovascular disease. We analysed demographic, clinical, diagnostic/therapeutic, and prognostic variables.
A total of 21 events were recorded: 8 ischaemic (38.1%) and 13 haemorrhagic strokes (61.9%). The mean age (SD) was 9.3 years (1.0). The sample included 12 boys and nine girls. No statistically significant differences were found between ischaemic and haemorrhagic strokes, except in the chief complaint (language and motor impairment in ischaemic stroke and headache in haemorrhagic stroke). None of the patients with ischaemic stroke received reperfusion therapies. Including the 3 patients who died during hospitalisation, eight patients (42.1%) had modified Rankin Scale scores > 2 at 12 months. Motor deficits were the most common sequela (n=9).
Though infrequent, paediatric stroke has an important functional impact. In Spain, Madrid was the first region to adapt the existing code stroke care networks for adult patients. In Aragon, this review has enabled us to work closely with the different stakeholders to offer a care plan for acute paediatric ischaemic stroke. Nevertheless, prospective national registries would be valuable to continue improving the care provided to these patients.
近年来，成人急性缺血性脑卒中的防治发生了重大变化。然而，儿科脑卒中的发病率较低，使得制定特定指南更加具有挑战性。本研究旨在阐明本地区儿童的情况，以便制定区域性方案，改善对这些患者的治疗。
我们对西班牙阿拉贡地区（1308728 人口，15%年龄≤15 岁）2008 年至 2019 年期间的儿科脑卒中（≤15 岁）进行了区域发病率研究。数据来自阿拉贡地区卫生服务局的医院出院记录，包括根据国际疾病分类（ICD）编码的脑血管疾病死亡记录。我们分析了人口统计学、临床、诊断/治疗和预后变量。
共记录了 21 例事件：8 例缺血性（38.1%）和 13 例出血性脑卒中（61.9%）。平均年龄（SD）为 9.3 岁（1.0）。样本包括 12 名男孩和 9 名女孩。缺血性和出血性脑卒中之间除了主要症状（缺血性脑卒中为语言和运动障碍，出血性脑卒中为头痛）外，无统计学差异。没有接受溶栓治疗的缺血性脑卒中患者。包括住院期间死亡的 3 例患者在内，12 个月时 8 例患者（42.1%）改良 Rankin 量表评分>2。运动障碍是最常见的后遗症（n=9）。
儿科脑卒中虽然少见，但对功能有重要影响。在西班牙，马德里是第一个为成人患者改编现有的脑卒中护理网络代码的地区。在阿拉贡，这项审查使我们能够与不同利益相关者密切合作，为急性儿科缺血性脑卒中患者提供护理计划。然而，全国性的前瞻性登记将有助于继续改善对这些患者的治疗。
