[Ischemic cerebrovascular accidents in childhood].
Authors review 53 children, aged 0 to 14 years, affected with cerebrovascular ischemic strokes. Largest aetiological groups were: a) congenital heart disease, 16 patients; b) arteritis of unknown cause, 11; c) idiopathic arterial occlusion without arteritis images on angiography, 7; d) moyamoya disease, 6; and d) local or systemic infections, 5. The mode of onset was as completed stroke in 72% and stroke in evolution in 24%. After acute stage 17.6% of patients presented other definitive strokes, 11.7% suffered only transient ischemic strokes (TIA), and 4% reversible ischemic neurologic deficits (RIND). Mean follow-up was 4.36 years, 9.8% of patients died, 11.8% recovered completely and 52.9% improved after initial stroke. Poor global evolution was associated with heart disease (p less than 0.05) and with onset of strokes before age 2 (p less than 0.05). Most important sequelae, besides motor impairment, were epilepsy (49%) and mental retardation (50% got less than IQ 80). Late epilepsy was associated with seizures at onset (p less than 0.05). Clinical factors of adverse mental development were: a) seizures at onset, b) late epilepsy and c) stroke before age 2. 66% of cases had two or more arterial lesions in the same or in different arterial trees. Therefore, embolic and arteritic factors probably play an important role in infancy and childhood stroke.
Pascual Pascual
S I
SI
Centro Nacional ATAM, Clínica Infantil La Paz, Madrid.
Pascual Castroviejo
I
I
Vélez
A
A
D000293:Adolescent; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007223:Infant; D002542:Intracranial Embolism and Thrombosis / Q000150:complications; D008297:Male; D009069:Movement Disorders / Q000209:etiology; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies
Accidentes cerebrovasculares isquémicos en la infancia.