[Arterial ischaemic stroke in children with cardiac diseases].
BACKGROUND
The incidence of cerebral stroke in children has significantly increased in last years. Heart diseases are one of the best known risk factors in pediatric stroke. AIM. To describe the characteristics of the cerebral stroke in children with heart diseases, emphasizing in predisposing conditions, time to diagnosis, management and follow-up of patients.


METHODS
We performed a retrospective study in children suffering from heart diseases with cerebral stroke admitted to our hospital that comprised 10 years. Type of cardiopathy, associated factors like surgery or catheterization, study of thrombophilia, clinical findings, methods and time to diagnosis, primary and secondary prophylaxis, treatment and long-term neurologic outcome were analyzed.


RESULTS
Twenty patients were included in our study (age: from neonatal period to 15 years), eighteen of them were children with congenital cardiac disease. Eleven patients had antecedent of surgery and/or catheterism in the previous month. The most common clinical presentation was focal seizures. Time from clinical onset to diagnosis of stroke was longer than 24 hours in 60% of our patients. Fifty per cent of our patients did not receive any primary prophylaxis. Treatment was initiated in 70% of patients, but no one received thrombolysis.


CONCLUSIONS
It is crucial to consider stroke when children with heart diseases show any neurologic symptom. Optimal diagnostic strategies must be established to low the delay of diagnosis in these patients, as well as randomised clinical trials in order to establish uniform guidelines in pediatric stroke.
Huidobro-Fernández
B
B
Hospital General Universitario Gregorio Marañón, Madrid, España.
Tolín-Hernani
M M
MM
Vázquez-López
M
M
Martín-Del Valle
F
F
de Castro-De Castro
P
P
D000293:Adolescent; D002545:Brain Ischemia / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*