儿童急性动脉缺血性脑卒中的诊治进展

Progress on diagnosis and treatment of acute arterial ischemic stroke in children

卒中是儿童致死或致残的重要原因,动脉缺血性卒中(AIS)发病率呈增加趋势。儿童AIS临床表现不典型,病因不同于成人且复杂多样。MRI(含DWI序列)是首选神经影像学检查。时间因素在儿童AIS中与成人同等重要。静脉溶栓治疗在儿童AIS的安全性和有效性尚需更多的临床研究证实,机械取栓可能具有一定优势。抗血栓治疗总体安全且药物之间并无优劣之分,但疗效尚不确定。关于儿童AIS的临床诊疗,仍有很多问题需要解答。

Stroke is an important cause of morbidity and mortality in children.The incidence of arterial ischemic stroke(AIS)is increasing.The clinical manifestations of AIS in children are atypical,and the risk factors for AIS in children are different from those in adults.MRI(including DWI sequence)is the preferred neuroimaging examination.The factor of time in children with AIS is as important as with adults.More clinical studies are needed to confirm the safety and effectiveness of intravenous thrombolysis therapy in children with AIS,and mechanical thrombectomy may have certain advantages.Antithrombotic therapy is generally safe,but the efficacy is still uncertain.There are still many questions to be answered regarding the clinical diagnosis and treatment of children with AIS.