Department of Paediatric Emergency Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland.
School of Medicine, Women's and Children's Health, University College Dublin, Dublin, Ireland.
Ir J Med Sci. 2023 Oct;192(5):2467-2473. doi: 10.1007/s11845-022-03236-y. Epub 2022 Dec 1.
Paediatric stroke is a rare event, and timely intervention is required to minimise long-term disability, reduced quality of life and financial implications. Although reperfusion strategies such as thrombolysis and thrombectomy are now well established in the adult population, and paediatric consensus guidelines allow for reperfusion therapies in children, access is currently limited due to diagnostic delays. This challenge is partly due to the rarity of presentation, infrastructure and public awareness to support early diagnosis as exists in the adult setting. We use an illustrative case and literature to describe an achieved case of paediatric stroke within an Irish setting.
We use the case of an 8-month-old male infant presenting with acute-onset left-sided hemiplegia to illustrate what can be achieved in an Irish setting.
Stroke was identified quickly following presentation, timely neuroimaging and multidisciplinary involvement with disposition to paediatric intensive care unit where thrombolysis was administered. Although the patient has some speech delay, he is recovering well with normal gross motor function.
Paediatric stroke care should be available to all children presenting with acute stroke symptoms; however, the rarity of the diagnosis would suggest a national strategy will be required to provide equitable care at a national level.
儿科中风是一种罕见的疾病，需要及时干预以最小化长期残疾、生活质量下降和经济影响。尽管溶栓和取栓等再灌注策略在成人中已得到广泛应用，并且儿科共识指南允许对儿童进行再灌注治疗，但由于诊断延迟，目前这些治疗方法的应用受到限制。这种挑战部分归因于与成人环境中存在的支持早期诊断的基础设施、公众意识和诊断延迟有关的罕见表现。我们使用一个说明性的病例和文献来描述爱尔兰儿科中风的一个成功病例。
我们使用一名 8 个月大的男性婴儿出现急性左侧偏瘫的病例来说明在爱尔兰环境中可以实现什么。
患者在出现症状后迅速诊断出中风，及时进行神经影像学检查，并多学科参与，将其转至儿科重症监护病房进行溶栓治疗。尽管患者存在一些言语延迟，但他的恢复情况良好，运动功能正常。
所有出现急性中风症状的儿童都应能获得儿科中风治疗；然而，由于这种诊断非常罕见，因此需要制定国家策略，以在全国范围内提供公平的护理。
