Ischemic stroke in paediatrics - narrative review of theliterature and two cases
2017
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.
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