[Incidence and characteristics of cerebrovascular disorders in children--critical analysis of 120 cases experienced at a children's general hospital].
Cerebrovascular disorders in children is a rare clinical entity, epidemiologic studies of which are very scarce in Japan. Hence this study analyzed 13,131 sick children admitted to Children's General Hospital in light of the incidence of cerebrovascular accident in children and its specific characteristics. In this paper, the cases of cerebral infarct are analyzed with special reference to their developmental outcomes. The results show that one hundred twenty children (0.85 percent of all sick children) had cerebrovascular disorders documented both in clinical pictures and CT scans. This number accounted for 2.5% of 4,738 CT examinations performed for these sick children. There were 79 cases of intracranial hemorrhage, 24 of cerebral infarction and 17 of vascular anomalies, 65.8%, 20.0% and 14.2% respectively. In the intracranial hemorrhage group, there was a different pathophysiology in each age group. The fact that intraventricular hemorrhage occurred in premature neonates, subarachnoid or posterior fossa subdural hemorrhage in mature neonates and infants, and intracerebral hematoma in elder children due to different causes was very striking. In the cerebral infarct group, the middle cerebral artery was most commonly affected (11 out of 24 cases); others had various lesions such as lacunar stroke, internal carotid artery occlusion and so on. The most impressive but disappointing fact in those children was that their clinical pictures were quite miserable, revealing low IQs. Nine out of 24 children with cerebral infarct had IQs below 20. In the abnormal vessels group, there were Moyamoya disease, arteriovenous malformation, intracranial aneurysm, Sturge-Weber syndrome, Menkes disease and coiling of the internal carotid or vertebral arteries each demonstrating unique angiographic findings.(ABSTRACT TRUNCATED AT 250 WORDS)
Oi
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Yamada
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Sasaki
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Matsumoto
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D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002544:Cerebral Infarction / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D006801:Humans; D007360:Intelligence; D002532:Intracranial Aneurysm / Q000453:epidemiology; D002538:Intracranial Arteriovenous Malformations / Q000150:complications; D007564:Japan; D009072:Moyamoya Disease / Q000453:epidemiology