Ischemic stroke in paediatrics - narrative review of the literature and two cases.
Stroke is a rare condition in childhood with an estimated incidence of between 1.3-13/100.000 patients. Clinical manifestation and risk factors for paediatric stroke are different from those of adults. The uncommon incidence, age-associated difference and plethora of clinical symptoms make the diagnosis of such strokes extremely difficult and often delayed. The history and clinical examination should point to diseases or predisposing factors. Neuroimaging (DWI MR) is the golden standard for diagnosis of paediatric stroke and other investigations can be considered according to the clinical condition. Despite advances in paediatric stroke research and clinical care, questions remain unanswered regarding acute treatment, secondary prevention and rehabilitation. The treatment recommendations are mainly extrapolated from studies on adult populations. In the review authors summarized the clinical characteristics and diagnostic steps for stroke in children/adolescents based on the most recent international guidelines and practical directions for recognising and managing the child/adolescent with stroke in paediatric emergency. In the two case reports, we describe the clinical course in both stroke patients.
Department of Paediatric Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Jozef
J
Klucka
Department of Paediatric Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Petr
P
Stourac
Department of Paediatric Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Roman
R
Stoudek
Department of Paediatric Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Michaela
M
Toukalkova
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Hana
H
Harazim
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Martina
M
Kosinova
Department of Radiology, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Alena
A
Stouracova
Department of Neurosurgery, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Andrej
A
Mrlian
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Petr
P
Suk
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
Jan
J
Malaska
D000293:Adolescent; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D059906:Neuroimaging / Q000379:methods; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis*; D000071939:Stroke Rehabilitation / Q000379:methods; D016896:Treatment Outcome
childhood/adolescence; diagnosis; outcome; stroke; therapy