Eggers C
Fortschr Neurol Psychiatr Grenzgeb. 1977 Mar;45(3):168-86.
Neurologic hemisyndromes in childhood may be due to congenital or acquired changes in cerebral vessels. Among the congenital vascular malformations, which very rarely become manifest already in children, the arteriovenous angiomata and saccular aneurysms are relatively the most common (in childhood about 4-8% manifest, 1-2% of all diseases). Venous angiomata, micro-angiomata and congenital dissecting aneurysms are very rare. But acquired thrombotic blocks of cerebral arteries are of greater importance as causes of acute neurologic hemisyndromes in childhood. Most often they have an inflammatory or traumatic cause, often the cause is unknown. Rare diseases only very recently described as arterial blocks of cerebral vessels are fibromuscular dysplasia and Moya-Moya-disease, the etiology of which is not yet fully understood. The prognosis of these diseases is generally unfavorable, but the focal signs in migraine as visual, sensory, aphasic and motoric defector irritative signs are as a rule reversible. In order to establish, where possible, the cause of acute neurologic hemisyndromes in childhood, early angiography may-classic migraine accompagnee types excepted-help. But also modern biochemical, immunologic, virologic, serologic, bacteriologic, clotting analytic and, possibly, histologic and histochemical techniques should be employed with particular attention to fat metabolism and to auto-immune disease.
儿童期的神经学性偏侧综合征可能归因于脑血管的先天性或后天性改变。在先天性血管畸形中,动静脉血管瘤和囊状动脉瘤相对最为常见(在儿童期约4 - 8%有临床表现,占所有疾病的1 - 2%),而这些畸形在儿童期很少就已显现。静脉血管瘤、微血管瘤和先天性夹层动脉瘤非常罕见。但后天性脑动脉血栓形成在儿童急性神经学性偏侧综合征病因中更为重要。它们大多有炎症或创伤性病因,病因往往不明。纤维肌发育不良和烟雾病是最近才被描述为脑血管动脉阻塞的罕见疾病,其病因尚未完全明了。这些疾病的预后通常不佳,但偏头痛中的局灶性体征,如视觉、感觉、失语和运动缺陷或刺激性体征,通常是可逆的。为了尽可能确定儿童急性神经学性偏侧综合征的病因,早期血管造影可能会有帮助(典型偏头痛伴随类型除外)。但还应采用现代生化、免疫、病毒、血清、细菌、凝血分析技术,可能还包括组织学和组织化学技术,尤其要关注脂肪代谢和自身免疫性疾病。