Radiological and clinical aspects and differences of childhood stroke
Keywords:
stroke in children, imaging diagnostics, childhood stroke risk factorsAbstract
Introduction: Stroke is a rather rare reason of neurological disorders in pediatric patients, but it may be an important cause of abnormalities in child development, thereby influencing the future of a sick child. Therefore, it is very important to confirm this condition as soon as possible using diagnostic imaging, in order to implement the proper treatment and to find out the cause and potential risk factors, which would enable the prediction of prognosis and the protection against next incidents in the future.
Aim: The aim of the study was to estimate the frequency of stroke in a group of pediatric patients hospitalized in the Department of Pediatric Neurology of the District Hospital No. 2 in Rzeszów in years 2003–2009 and the analysis of clinical symptoms and diagnostic process, most common risk factors, causes and locations of stroke in children.
Materials and methods: We analysed in details clinical data and laboratory tests in a group of children with stroke confirmed by diagnostic methods like CT or MR. Imaging diagnostics and a wide panel of laboratory tests were performed in all the patients in search of causes and risk factors for stroke.
Results: Stroke was confirmed in 18 children - in 8 cases it was ischaemic and in 10 haemorrhagic stroke. Ischaemic changes were located in the region of vascularization of internal carotid artery, medial cerebral artery, vertebral arteries and basal artery. Hemorrhagic changes were located in the cerebral and cerebellar hemispheres. Vascular malformations were the most frequent cause of haemorrhagic stroke, whereas heart defects, vascular abnormalities and metabolic disorders were the most common cause of ischemic stroke.
Conclusions: All children with clinical symptoms of stroke should be immediately diagnosed by computed tomography or magnetic resonance and should be done laboratory tests to find etiology of stroke, bearing in mind that the effects of rehabilitation after vascular incident depend on a quickly obtained correct diagnosis and implementing of an appropriate treatment.
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