Heterogeneity of etiological factors in pathogenesis of cerebral strokes in children
Keywords:
pathogenesis of cerebral strokes, children, etiological factors, diversityAbstract
The incidence of a cerebral stroke in the population of children is considered to be a rare phenomenon, although an increasing number of cases is noticeable. The problems of an excessive time lapse from the occurrence of clinical symptoms to the cerebral stroke recognition in children, the elaboration of effective prophylaxis and treatment standards, decrease in mortality as well as minimizing permanent damages, still remain open. By understanding the complexity and diversity of etiological factors of cerebral strokes the solution to the above problems may be facilitated. The publication is an attempt to systematize the data available in literature, concerning the diversity of etiological factors in pathogenesis of cerebral strokes in children. The following have been discussed: inflammatory and non-inflammatory arteriopathies, intracranial aneurysms, intravascular malformations; cardiac diseases; critical states; disorders of haemostasis and embolism; irregularities in the morphotic composition of blood; embolisms: fat embolisms, air embolisms, cancer embolisms, nitrogen embolisms, foreign body embolisms; metabolic diseases; endocrine diseases, including those genetically determined; other risk factors; cerebral strokes and the prenatal and perinatal periods; drugs and cerebral strokes. Co-occurrence of the risk factors and the possibility of modifying some of them have been highlighted. A cerebral stroke is a multifactorial etiological syndrome, thus having established one factor, searching for others should be continued. The knowledge of the diversity of factors which play a role in the cerebral stroke etiopathogenesis in children is a starting point to establish primary and secondary prophylaxes which aim for lowering the incidence and recurrence risks, as well as the treatment. The preventive activities are always the most effective.
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