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大脑中动脉区域动脉缺血性脑卒中后,丘脑体积丢失在儿童中比在成人中更明显。

Thalamic Volume Loss Is Greater in Children Than in Adults Following Middle Cerebral Artery Territory Arterial Ischemic Stroke.

机构信息

Computational Bioscience Program, University of Colorado Anschutz, Aurora, CO, USA.

Department of Neurology, 12225University of Colorado School of Medicine, Aurora, CO, USA.

出版信息

J Child Neurol. 2022 Oct;37(10-11):882-888. doi: 10.1177/08830738221118807. Epub 2022 Sep 7.

Abstract

Younger stroke patients may suffer worse outcomes than older patients; however, the extent to which age at stroke impacts remote areas of the brain remains unclear. The objective of this study was to determine thalamic volume changes ipsilateral to middle cerebral artery territory strokes based on age at acute ischemic stroke onset. Acute ischemic stroke patients <9 years, 9-18 years, and >18 years old were retrospectively recruited from a large quaternary care system. Each subject underwent an acute (<72 hours from AIS) and chronic (>90 days) magnetic resonance imaging (MRI) scan. Manual thalamic segmentation was performed. Younger and older children had significantly greater stroke-side thalamic volume loss compared to adults (48.2%,  = .022; 40.7%,  = .044, respectively). Stroke-side thalamic volumes decreased across the age spectrum but to a greater degree in pediatric patients. This observation can affect functional and cognitive outcomes post stroke and warrants further research.

摘要

年轻的脑卒中患者的预后可能比老年患者差;然而,脑卒中发生时的年龄对大脑远隔区域的影响程度尚不清楚。本研究的目的是根据急性缺血性脑卒中发病时的年龄,确定大脑中动脉区域脑卒中对侧丘脑体积的变化。从一个大型的四级护理系统中回顾性招募了年龄<9 岁、9-18 岁和>18 岁的急性缺血性脑卒中患者。每位患者均接受了急性(AIS 后<72 小时)和慢性(>90 天)磁共振成像(MRI)扫描。手动进行丘脑分割。与成年人相比,年龄较小和较大的儿童的患侧丘脑体积损失明显更大(分别为 48.2%,=0.022;40.7%,=0.044)。随着年龄的增长,患侧丘脑体积逐渐减小,但在儿科患者中更为明显。这一观察结果可能会影响脑卒中后的功能和认知结果,需要进一步研究。

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本文引用的文献

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Evaluation and Acute Management of Ischemic Stroke in Infants and Children.婴幼儿缺血性卒中的评估与急性处理
Continuum (Minneap Minn). 2018 Feb;24(1, Child Neurology):150-170. doi: 10.1212/CON.0000000000000559.

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