| Objective:To study the characteristics of Chinese pediatric arterial ischemic stroke (AIS) in southwest of China, and exam the etiology and risk factor that are provided as a basis for the evidence of early diagnosis and precautionary approaches in children.Methods:This study retrospectively reviewed the records of58patients in both department of neurology and department of neurosurgery in Children’s hospital of Chongqing medical university from January2003to March2011, and patients were eligible for analysis if they had been diagnosed with AIS. The characters, etiologies and risk factors were described and the relation between trivial head injury and basilar ganglia calcification were analyzed through SPSS17.0system.Results:(1)31males and27females were enrolled in the study, with age of2moths and3days to13years (average age was3years and10months), in the cases studied, there were7patients older than1month and younger than1year (12.1%),21patients aged between1year and3years (36.2%),17patients aged between3years and6years (29.3%), and13patients aged between6years and13years (22.4%), the peak morbidity period was during toddler period and before school period.(2) The period between stroke onset and admission was3hours at least and3months at most, the average time was6.8days. And the average period of58patients with AIS in hospital was11.45days.(3) In the58cases reviewed, major clinical neurological manifestations are paralysis (n=52,92.8%), central seventh nerve palsy (n=34,58.6%), motor aphasia (n=16,27.6%), vomiting and headache (n=11,19.0%), loss of consciousness (n=8,13.8%), and convulsion (n=7,12.1%).(4) In reviewed58cases,40had radical vascular exams, in which33showed abnormalities (82.5%), which presented as stenosis or occlusion of arteries on MRA or CTA. In the33cases, the left middle cerebral artery was involved in19cases (47.5%), internal carotid arteries were involved in16cases (40.0%, the left and right internal carotid artery was involved in8cases respectively), he right middle cerebral artery was involved in14cases (35.0%), the basal artery was in4cases, disappearance of Willis circle in one case, the angiography (MRA or CTA) of7cases (17.5%) didn’t present any stenosis or occlusion.(5) In the58case with AIS reviewed, major risk factors were trivial head injury (n=26,44.8%), moyamoya disease (n=8,13.8%) and intracranial infection (n=5,10.3%),22cases (37.9%) had respiratory infection, and6cases (10.3%) had no defined risk factor or etiologies. (6) In the58cases studied,18cases (31.0%) had more than one etiology, in which,15cases had two etiologies or risk factors, two cases had3, and1case had4.Conclusions:(1) The period between stroke onset and admission of the58cases with AIS was6.8days on average, the peak morbidity period was during toddler period and before school period, and patients from countries were more than that from urban fields.(2) In the58cases reviewed, major clinical neurological manifestations are paralysis, and the right paralysis was more common than the left one, other common neurological manifestations were central seventh nerve palsy, motor aphasia, vomiting and headache, and so on.(3) In reviewed40patients with AIS who had radical vascular exams, stenosis or occlusion of middle cerebral artery was major radical image, and the left one involved more than the right one, another common involved artery was internal carotid artery, however, the angiography (MRA or CTA) of7cases didn’t present any stenosis or occlusion.(4) In the58cases of children with AIS, main risk factors were trivial head injury, moyamoya disease and intracranial infection. Many patients had upper respiratory infection before stroke onset or during the course. And prevention of infectious disease, induction of head injury are effective to prevention of AIS in Chinese children, and image examination of head and intracranial vascular as soon as possible is beneficial to early diagnosis. |
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