The recurrence risk of ischemic stroke in childhood

被引:15
作者
Brankovic-Sreckovic, V
Milic-Rasic, V
Jovic, N
Milic, N
Todorovic, S
机构
[1] Univ Belgrade, Fac Med, Clin Child Neurol & Psychiat, Belgrade, Serbia Montenag, Serbia
[2] Univ Belgrade, Fac Med, Inst Med Stat, Belgrade, Serbia Montenag, Serbia
关键词
stroke; childhood; recurrence rate;
D O I
10.1159/000076955
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine the risk of recurrence of ischemic stroke in children and to evaluate the influence of etiological factors and underlying mechanisms on recurrence rate. Subjects and Methods: Thirty-six children ( 21 boys and 15 girls) with clinically and radiographically proven ischemic cerebral infarction were prospectively followed up over a period of 1 - 9 years ( median 5 years 5 months). The median age of onset of stroke was 8.4 years ( 1 - 16 years). Patients with hemorrhagic stroke, neonatal infarction and sinovenous thrombosis were not included. The patients were analyzed according to the mechanisms and etiology of the initial and recurrent stroke event. Results: For the initial stroke, cardioembolic (33.3%) and arteriopathic processes (36.1%) were identified as the most probable mechanisms of arterial ischemic stroke. Prothrombotic abnormalities were found in 4 children (11.1%). Underlying pathology in the remaining 7 (19.4%) was not known. Recurrent ischemic infarction was diagnosed in 5 children (13.9%) within 5 days to 18 months ( median 6 months) after the first stroke manifestation. In 3 of them stroke recurrence was due to cardiac or transcardiac embolism. Cardiac abnormality prior to the first stroke was detected in 1 child. Clinically silent multiple cerebral infarcts disclosed by MRI preceded the overt stroke episode in 2 patients. Conclusion: Congenital and acquired heart diseases were the most common cause of repeated stroke in our study. The risk of recurrence appeared to be fivefold higher in children with cardiac disease irrespective of the coexistence of other risk factors. The risk factors of stroke in children were multiple and overlapping. Consequently, recognition of the major one and its underlying mechanism is crucial for both effective therapeutic approach and the prevention of recurrence. Copyright (C) 2004 S. Karger AG, Basel.
引用
收藏
页码:153 / 158
页数:6
相关论文
共 27 条
  • [1] Chickenpox and stroke in childhood - A study of frequency and causation
    Askalan, R
    Laughlin, S
    Mayank, S
    Chan, A
    MacGregor, D
    Andrew, M
    Curtis, R
    Meaney, B
    deVeber, G
    [J]. STROKE, 2001, 32 (06) : 1257 - 1262
  • [2] Stroke in childhood: Outcome and recurrence risk by mechanism in 59 patients
    Chabrier, S
    Husson, B
    Lasjaunias, P
    Landrieu, P
    Tardieu, M
    [J]. JOURNAL OF CHILD NEUROLOGY, 2000, 15 (05) : 290 - 294
  • [3] deVeber G, 2000, Semin Pediatr Neurol, V7, P309, DOI 10.1053/spen.2000.20074
  • [4] Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis
    deVeber, GA
    MacGregor, D
    Curtis, R
    Mayank, S
    [J]. JOURNAL OF CHILD NEUROLOGY, 2000, 15 (05) : 316 - 324
  • [5] Arterial dissection and stroke in children
    Fullerton, HJ
    Johnston, SC
    Smith, WS
    [J]. NEUROLOGY, 2001, 57 (07) : 1155 - 1160
  • [6] Outcome after ischaemic stroke in childhood
    Ganesan, V
    Hogan, A
    Shack, N
    Gordon, A
    Isaacs, E
    Kirkham, FJ
    [J]. DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2000, 42 (07) : 455 - 461
  • [7] Psychological aspects of hemiplegia
    Goodman, R
    [J]. ARCHIVES OF DISEASE IN CHILDHOOD, 1997, 76 (03) : 177 - 178
  • [8] Functional outcome following stroke in children
    Gordon, AL
    Ganesan, V
    Towell, A
    Kirkham, FJ
    [J]. JOURNAL OF CHILD NEUROLOGY, 2002, 17 (06) : 429 - 434
  • [9] Genetics and ischaemic stroke
    Hassan, A
    Markus, HS
    [J]. BRAIN, 2000, 123 : 1784 - 1812
  • [10] PREDICTORS OF SURVIVAL AND CHARACTERISTICS OF CHILDHOOD STROKE
    HIGGINS, JJ
    KAMMERMAN, LA
    FITZ, CR
    [J]. NEUROPEDIATRICS, 1991, 22 (04) : 190 - 193