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paediatric stroke

Jozef Klucka, Petr Stourac, Roman Stoudek, Michaela Toukalkova, Hana Harazim, Martina Kosinova, Alena Stouracova, Andrej Mrlian, Petr Suk, Jan Malaska
BACKGROUND: 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...
November 10, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Salome Kornfeld, Martina Studer, Stephanie Winkelbeiner, Mária Regényi, Eugen Boltshauser, Maja Steinlin
AIM: Paediatric arterial ischaemic stroke can lead to reduced quality of life (QoL). It is important to identify predictors of QoL to support recovery. We examined long-term QoL after arterial ischaemic stroke concerning different variables. METHOD: Children registered in the Swiss Neuropediatric Stroke Registry and suffering from arterial ischaemic stroke between 2000 and 2008 were included. Two years post-stroke, assessments included intelligence quotient tests for cognitive impairment and modified Rankin Scale (mRS) for neurological impairment; 5 years post-stroke, the Kidscreen-27 was used for QoL, DSM-IV criteria screening was used for attention deficits, and the ABILHAND-Kids was used for manual motor skills...
October 21, 2016: Developmental Medicine and Child Neurology
Lucio Parmeggiani, Michela Salandin, Flavio Egger, Fiorenzo Lupi, Marco Primerano, Giorgio Radetti
AIM: Migraine affects approximately 10-20% of the general population, including children and adolescents, and an association between migraine and increased risks for cardiovascular disease and stroke have been reported in adult patients. This study aimed to address the lack of data on children with migraine. METHODS: This study comprised 30 children and adolescents (16 male) with migraine. We evaluated their biochemical profile, glucose homeostasis, vascular function by flow-mediated dilatation and arterial structure by carotid intima-media thickness (cIMT)...
December 2016: Acta Paediatrica
Alain J Poncelet, Gébrine El Khoury, Laurent De Kerchove, Thierry Sluysmans, Stéphane Moniotte, Mona Momeni, Thierry Detaille, Jean E Rubay
OBJECTIVES: To analyse our institutional results in the setting of paediatric aortic valve (AV) repair. Primary end-points were overall survival, freedom from AV reoperation and freedom from AV replacement. METHODS: A retrospective analysis of all patients under 18 years of age operated on from 1977 to 2015 in a single tertiary care level institution. Patients were included if they benefited from any type of AV repair procedure, including commissurotomy, leaflet shaving or plication, or leaflet augmentation...
September 28, 2016: European Journal of Cardio-thoracic Surgery
Eleni Papathanasiou, Mathilde Chevignard, Carole Vuillerot, Anne Tiberghien, Ingrid Godard
OBJECTIVE: Paediatric stroke is a relatively rare medical condition, but it often leads to long lasting motor and cognitive impairments. Rehabilitation of motor impairments has been widely studied, with most studies performed in children with cerebral palsy (CP). However, CP covers a variety of medical conditions, including brain lesions due to paediatric stroke occurring early in life, but not stroke occurring later on during childhood. The specificity of rehabilitation after paediatric stroke remains understudied...
September 2016: Annals of Physical and Rehabilitation Medicine
Deogratias Munube, Elly Katabira, Grace Ndeezi, Moses Joloba, Samden Lhatoo, Martha Sajatovic, James K Tumwine
BACKGROUND: Stroke is a major complication of sickle cell anaemia (SCA). It occurs commonly in childhood with about 10 % of children with sickle cell anaemia getting affected by this complication. In Uganda, there is paucity of data on the prevalence of stroke in children admitted in a tertiary institution. We determined the prevalence of stroke amongst children with SCA admitted to Mulago National Referral Hospital in Uganda and described the ir co-morbidities. METHODS: We conducted a retrospective record review of children with SCA admitted from August 2012 to August 2014 to the Paediatric Haematology Ward of Mulago Hospital in Kampala, Uganda...
September 17, 2016: BMC Neurology
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Virginia Mirra, Sergio Bernasconi
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...
August 27, 2016: Italian Journal of Pediatrics
Magda Kaczor, Michał Skalski
Insomnia presents an increasing and significant health issue in paediatric population. As the problem had grown over past decade, it became recognised by the specialists dealing with children and adolescents. In a recent study American Academy of Child and Adolescent Psychiatry members were asked about their experience with patients complaining about sleep disturbances. Doctors reported that sleep was a problem for 1/3 of their patients out of which 1/4 required pharmacotherapy [1]. Multiple studies concerning adults confirmed significance of healthy sleep in optimal cognitive, emotional, social and biological functioning...
2016: Psychiatria Polska
Lucia Gerstl, Martin Olivieri, Florian Heinen, Ingo Borggraefe, Andreas Sebastian Schroeder, Moritz Tacke, Katharina Vill, Robert Dalla-Pozza, Karl Reiter, Juergen Lutz, Hartmut Brueckmann, Hendrik Janssen
BACKGROUND: Paediatric stroke is a potentially life-threatening emergency and requires immediate treatment to improve clinical outcome. In contrast to adult treatment recommendations, little is known about safety and efficacy of thrombolysis and mechanical thrombectomy in children. CASE DESCRIPTION AND CONCLUSION: We report on a three-year-old boy with a cardioembolic intracranial two-vessel occlusion and successful therapy with thrombolysis and mechanical thrombectomy...
November 2016: European Journal of Paediatric Neurology: EJPN
Aye Aye Khine, David Adrian Marais
BACKGROUND: The prevalence of cardiovascular disease is projected to be 38.7% for the USA in 2020, including coronary heart disease at 8.6% and stroke at 3.6%. In South Africa (SA), premature deaths due to heart and blood vessel diseases in people of working age (35 - 64 years) have been predicted to increase by 41% between 2007 and 2030, with enormous negative economic impact. Atherosclerosis underlies much of the pathogenesis, which involves risk factors including dyslipidaemia. Secondary dyslipidaemia associated with diabetes mellitus, hypothyroidism, chronic renal disease, cholestasis, nephrotic syndrome, alcohol excess, drugs such as thiazide diuretics and antiretroviral agents may respond to treatment of underlying causes, but residual dyslipidaemia may in such cases be due to primary disorders of metabolism...
July 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Christopher Johns, S Kolla, A Hart, S Sinha, R Batty, D J A Connolly
Stroke is recognised as an important disease in adults. Paediatric stroke is less understood, yet still an important cause of morbidity and mortality, with an incidence of 5 per 100 000 children and is one of the top 10 leading causes of death in children. In adults the vast majority of strokes are ischaemic, whereas in children haemorrhage makes up half the cases. The incidence of neonatal stroke is much higher, at up to 45 per 100 000 population; however, the underlying causes are less understood. This paper acts as a guide to the different causes of stroke with the key differences on imaging discussed...
September 2016: Postgraduate Medical Journal
Jamie M Kawadler, Jonathan D Clayden, Chris A Clark, Fenella J Kirkham
AIM: Sickle cell disease (SCD) is the commonest cause of childhood stroke worldwide. Magnetic resonance imaging (MRI) is routinely used to detect additional silent cerebral infarction (SCI), as IQ is lower in SCI as well as stroke. This review assesses the effect of infarction on IQ, and specifically whether, compared to healthy controls, IQ differences are seen in children with SCI with no apparent MRI abnormality. METHOD: A systematic review was conducted to include articles with an SCD paediatric population, MRI information, and Wechsler IQ...
July 2016: Developmental Medicine and Child Neurology
Andrew A Mallick, Vijeya Ganesan, Fenella J Kirkham, Penny Fallon, Tammy Hedderly, Tony McShane, Alasdair P Parker, Evangeline Wassmer, Elizabeth Wraige, Sam Amin, Hannah B Edwards, Mario Cortina-Borja, Finbar J O'Callaghan
OBJECTIVE: Arterial ischaemic stroke (AIS) is an important cause of acquired brain injury in children. Few prospective population-based studies of childhood AIS have been completed. We aimed to investigate the outcome of childhood AIS 12 months after the event in a population-based cohort. METHODS: Children aged 29 days to less than 16 years with radiologically confirmed AIS occurring over a 1-year period residing in southern England (population 5.99 million children) were eligible for inclusion...
March 1, 2016: Annals of Neurology
Sarah J H Lalor, Monika A Formankiewicz, Sarah J Waugh
Crowding refers to the degradation of visual acuity for target optotypes with, versus without, surrounding features. Crowding is important clinically, however the effect of target-flanker spacing on acuity for symbols and pictures, compared to letters, has not been investigated. Five adults with corrected-to-normal vision had visual acuity measured for modified single target versions of Kay Pictures, Lea Symbols, HOTV and Cambridge Crowding Cards, tests. Single optotypes were presented in isolation and with surrounding features placed 0-5 stroke-widths away...
April 2016: Vision Research
Judith V Graser, Claudia Letsch, Hubertus J A van Hedel
BACKGROUND: The 10-Meter Walk Tests (10MWT) and the 6-Minute Walk Test (6MinWT) are applied to assess gait capacity in paediatric patients. To better objectify changes in qualitative aspects of gait, temporo-spatial parameters like stride length or step symmetry could be simultaneously assessed with a GAITRite system. Reliability has not yet been evaluated in a heterogeneous sample of children with various neurological gait disorders such as is representative for paediatric neuro-rehabilitation...
2016: BMC Neurology
Nadja Lindberg Bonne, Lars Evald, Jonas Kjeldbjerg Hansen
BACKGROUND: The cerebellar cognitive affective syndrome (CCAS), is characterised by disturbances in executive functions, visuospatial difficulties, personality changes, and linguistic difficulties. It is well described in other diseases of the cerebellum such as tumour resection and cerebellar stroke but has not previously been described in detail in paediatric cases of acute post-infectious ataxia (APCA). METHODS: Case study. A 12-year-old boy was admitted with severe ataxia, dysmetria, dysdiadokinesia, and dysarthria...
May 2016: European Journal of Paediatric Neurology: EJPN
Margherita Rosa, Silvana De Lucia, Victoria Elisa Rinaldi, Julie Le Gal, Marie Desmarest, Claudio Veropalumbo, Silvia Romanello, Luigi Titomanlio
Stroke is a rare disease in childhood with an estimated incidence of 1-6/100.000. It has an increasingly recognised impact on child mortality along with its outcomes and effects on quality of life of patients and their families. Clinical presentation and risk factors of paediatric stroke are different to those of adults therefore it can be considered as an independent nosological entity. The relative rarity, the age-related peculiarities and the variety of manifested symptoms makes the diagnosis of paediatric stroke extremely difficult and often delayed...
2015: Italian Journal of Pediatrics
Bruno Law-Ye, Guillaume Saliou, Frédérique Toulgoat, Marc Tardieu, Kumaran Deiva, Catherine Adamsbaum, Béatrice Husson
BACKGROUND: Moyamoya syndrome is characterised by an occlusion of the carotid terminations with the development of collateral vessels. Our objective is to describe a series of infants presenting early-onset moyamoya-like syndrome, which may constitute a distinct entity. METHODS: From a cohort of children with rare cerebral vascular pathologies, we studied eight infants (28 days-1 year) with early-onset moyamoya-like syndrome demonstrated by angiography. We retrospectively analysed the patterns on MRI and MRA, as well as all other available data...
August 2016: European Radiology
Nadine McCrea, Dawn Saunders, Emmanouil Bagkeris, Manali Chitre, Vijeya Ganesan
AIM: Review a series of children with posterior circulation arterial ischaemic stroke (PCAIS) to identify diagnostic modality and associations in cases of vertebral artery dissection (VAD). METHOD: Retrospective analysis of 30 cases of childhood PCAIS identified from two tertiary centres over 11 years. Clinical and demographic details were recorded. Brain and cerebrovascular imaging were reviewed. Aetiology was classified using the Childhood Arterial Ischaemic Stroke Standardized Classification and Diagnostic Evaluation criteria...
January 2016: Developmental Medicine and Child Neurology
Rohit Saxena, Andrew Durward, Sarah Steeley, Ian A Murdoch, Shane M Tibby
PURPOSE: Fluid overload is a risk factor for poor outcome in intensive care; thus volume loading should be tailored towards patients who are likely to increase stroke volume. We aimed to evaluate the paediatric predictive ability (stroke volume increase of at least 15 % after fluid bolus) of novel and established volumetric and dynamic haemodynamic variables, and assess the influence of baseline contractility on response. METHODS: We assessed 142 volume loading episodes (10 ml/kg crystalloid) in 100 critically ill ventilated children, median (interquartile) weight 10 (5...
December 2015: Intensive Care Medicine
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