儿童动脉缺血性脑卒中研究进展

Advances in childhood arterial ischemic stroke

很多全身性疾病可导致儿童动脉缺血性脑卒中（AIS），如脑动脉病。轻微感染在短暂性脑动脉病（TCA）中起重要作用。由于儿童卒中表现的非特异性以及医师对儿童AIS认识不足常常延误诊断和治疗。目前儿童AIS的治疗国内外尚无统一标准，急性期处理以支持疗法为主。儿童AIS的二级预防大多参照成年人治疗方案，预后并不乐观，一旦患病往往造成永久残疾，其中包括运动感觉损害、认知缺陷和癫痫等。

A wide range of underlying systemic factors have been reported in the setting of childhood stroke. Emerging research demonstrates that non-atherosclerotic intracerebral arteriopathies are the main risk factors. Minor infections may play a role in arteriopathies. Nonspecific presentation and doctor＇s lacking awareness of pediatric stroke both contribute to initial misdiagnoses that result in delays in management. Acute management of children with stroke is primarily supportive including control of fever, blood pressure normalization to accepted age ranges, normalization of glucose, and maintenance of normal oxygenation, but there is no golden standard therapy at home and abroad. For secondary stroke prevention, the majority of children are treated with adult stroke therapeutic schedule. The prognosis of childhood stroke is not satisfactory. Many of these children are left with permanent neurologic deficits including injury of motor, sensory and cognitive defect and epilepsy.