title: Cerebral infarct in children aged zero to fifteen years.
abstract: Cerebral infarcts in children present peculiar characteristics either due to their diversity of causes or due to the unknown nature of the causes. The etiologies of cerebral infarct were reviewed in children from zero to 15 years old, attended at a tertiary hospital, in Ribeirão Preto (Brazil), from 1990 to 1997, adopting the modified Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria of classification; 1-Atherosclerosis in large arteries; 2-Cardioembolic; 3-Occlusion of small vessels; 4-Other etiologies; 5-Undetermined cause. Thirty-nine children were included, 18 males and 21 females, aged 2 months to 15 years, mean age 5.67. The largest group, N=22 (56.4%), included children with "other etiologies", 7 of them aged under two years. The most common etiology was dehydration and septic shock leading to brain hypoperfusion and watershed infarcts. Nine (23%) children had "Undetermined etiology", 7 (17.9%) cardioembolic subtype and none had atherosclerosis. Laboratory improvement is needed for the large number of patients without a defined cause, and the high proportion of children with dehydration in the group with a determined cause emphasizes the need for preventive health actions among infants and children.
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
authors.forename: Thelma Ribeiro
authors.initials: TR
authors.lastname: Noce
authors.forename: Soraia Ramos Cabete
authors.initials: SR
authors.lastname: Fábio
authors.forename: José Ibiapina
authors.initials: JI
authors.lastname: Siqueira Neto
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: dos Santos
authors.forename: Carolina Araújo Rodrigues
authors.initials: CA
authors.lastname: Funayama
mesh_terms: D017677:Age Distribution; D002544:Cerebral Infarction / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male