Stroke Syndrome in Children
Articol din publicatia Timisoara Medical Journal nr. 2/2005
Full text [membership required, free registration]
Rodica Urtila, Ioan Popa, Dana Metea-Stefanescu, Simona Turcu
2nd Pediatrics Clinic, Victor Babes University of Medicine and Pharmacy, Timisoara
Rodica Urtila, 1-3 Paltinis Street, Timisoara
Acute stroke syndromes (ASS) represent a major cause of morbidity and mortality in adults, but are rarer in children, with an estimated incidence of 2.5-2.7/100,000. They are produced by a perturbation of cerebral circulation as a result of ischemia or hemorrhage, and the lesions being ischemic in 45% of cases and hemorrhagic in more than 50% of cases in pediatric pathology. ASS have a complex etiology, ranging from cardio-embolic causes, disorders of coagulation or vascular inflammations, in case of ischemic strokes, to cerebral vascular abnormalities, arteriovenous malformations or cerebral aneurisms in case of hemorrhagic accidents.
The most common consequences of ischemic strokes are motor, cognitive problems and epilepsy; the mortality being about 10%.
The prognosis of hemorrhagic strokes depends on their quantity and localization as well as on the consciousness status of the patient during the onset of hemorrhage. The mean mortality after a hemorrhagic episode is 20%, whereas the mortality after the surgical intervention is 0-13%. The incidence of relapse is about 13%.
The evolution goes towards motor deficiencies, epilepsy, behavioral modifications and school difficulties.