[Ischemic stroke in childhood and adolescence. A study of 46 cases in the south of Brazil].
BACKGROUND
Ischaemic stroke (IS) in childhood and adolescence is a condition that has received little attention from researchers and presents a multifactorial aetiology. In recent decades the rates of incidence seem to have risen, but underdiagnosis is still commonplace. It may appear as the first symptom of systemic disease in childhood, with the resulting devastating effects. Prothrombotic disorders represent important causal factors of ischaemic attacks in childhood.


OBJECTIVE
The aims of this study were to identify the factors associated to IS in infancy and adolescence, as well as to establish the causation and to determine the abnormalities in the coagulation proteins of the patients that were studied.


METHODS
A total of 46 patients diagnosed with IS, between 0 and 18 years of age, were included in the study over the period between March 2002 and September 2003. A number of lab tests were carried out, including analysis of coagulation proteins and echocardiograms.


RESULTS
Neonatal IS was found in almost a third of the cases and practically half the sample had some disease prior to the ischaemic event. In all, 20% of the patients showed no IS-associated disorders. The most frequent clinical presenting symptoms were convulsions and hemiparesis. Anomalies were detected in proteins S and C in 22 and 17% of the sample, respectively. The middle cerebral artery was the most affected vascular region.


CONCLUSIONS
IS-associated disorders were identified in most of the children and adolescents that were studied; moreover, prothrombotic risk factors are of great significance in the research into cases.
Ranzan
J
J
Unidad de Neurología Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. josiranzan@terra.com.br
Rotta
N T
NT
D000293:Adolescent; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000473:pathology