Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been...Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been rarely reported. This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke （PALS）. Methods The medical records of 42 PAlS patients （age range： 9 months to 13 years） treated at Wuhan Children＇s Hospital between July 2007 and January 2011 were retrospectively reviewed. Infarction location was first determined by craniocerebral computed tomography and magnetic resonance （MR） imaging. The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography. Results The majority of the 42 PAlS cases （66.7%, n=28） were 〈3 years old （vs. 〉3 years old： 33.3%, n=14; P〈0.05）, but the male： female ratio was similar in both groups （P〉0.05）. The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium, but convulsions were more prevalent in children 〈3 years-old. Children〉3 years-old mainly experienced the limited physical activity symptoms, including hemiparalysis, aphasia, and ataxia. For all 42 cases, the most frequent etiologies were infections （38.1%, n=16）, iron deficiency anemia （16.7%, n=7）, and moyamoya syndrome （11.9%, n=5）. The predominant infarcts among all cases were middle cerebral artery （63.6%, n=21） and basal ganglia （64.3%, n=27）. Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms, but more research is required.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">The purpose of our study was to investigate etiologies of ischemic stroke in the neurology university clinic of CNHU...<div style="text-align:justify;"> <span style="font-family:Verdana;">The purpose of our study was to investigate etiologies of ischemic stroke in the neurology university clinic of CNHU-HKM, Cotonou. <strong>Method: </strong>It was a cross-sectional, prospective and analytical study carried out from 1<span style="white-space:nowrap;"><sup>st</sup></span> November 2014 to 31<span style="white-space:nowrap;"><sup>st</sup></span> August 2015 in the neurology university clinic of CNHU-HKM. We included all patients with stroke whose ischemic nature was confirmed through brain CT scan or magnetic resonance imaging. Data analysis was conducted with Census and Survey Processing System (CSPRO). We carried out bivariate then multivariate analysis in identifying associated factors. Threshold value is estimated at p < 0.05. <strong>Results:</strong> 104 ischemic stroke patients participated in the study, representing 59.4% of all types of stroke. Mean age was 61.9 ± 12.3 years [26 - 87 years] with 1.6 as sex ratio. Among vascular risk factors, hypertension accounted for 85.6% of stroke cases. 29.8% suffered from aphasia. Embolic heart diseases and atherosclerosis were predominant, in a proportion of 53% and 26% respectively. Atrial Fibrillation (AF) accounted for 82% of embolic heart diseases. <strong>Conclusion:</strong> Etiologic investigation of stroke is important and should be systematically carried out. This study enabled to corroborate atherosclerosis predominance in etiologic investigation of ischemic stroke. Patients’ outcome could be improved by promptly managing the etiology through adoption of appropriate treatment.</span> </div>展开更多
<strong>Introduction:</strong> Stroke is the main cause of adult disability and the second most leading cause of death worldwide. The number of deaths due to stroke is 5.54 million worldwide. Globally, 70%...<strong>Introduction:</strong> Stroke is the main cause of adult disability and the second most leading cause of death worldwide. The number of deaths due to stroke is 5.54 million worldwide. Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low and middle-income countries. <strong>Method:</strong> This was a prospective observational cross-sectional study conducted at Indoor, Outdoor, Stroke and Neuro-Intervention clinic of the Department of Neurology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh, from June-2019 to May-2020. A total of 220 ischemic stroke patients aged above 30 years confirmed by CT scan/MRI of brain. Data were collected with a pre-structured questionnaire from the patients, investigations reports and face-to-face interviews and analyzed using IBM SPSS software version 23.0. Proper consent was taken from the participants. The collected data were ANNOVA tests and association within the risk factors and the patterns of subtypes of ischemic stroke where P < 0.05 considered significant. <strong>Results:</strong> Among the 220 stroke patients, large-artery atherosclerosis (LAA), cardio-embolism (CE), small-vessel occlusion (SVO, stroke of other determined etiology (SODE) and stroke of undetermined etiology (SUDE) were being observed 84 (38.18%), 14 (6.36%), 63 (28.64%), 12 (5.45%) and 47 (18.18%). Eighty-Six (39.09%) prevalence of subtypes was found in rural areas whereas 134 (60.91%) were in urban areas. The significant risk factors are associated with the prevalence of various subtypes (p < 0.05). <strong>Conclusion:</strong> This study prevails the people of Bangladesh are vulnerable to various subtypes of ischemic stroke. The higher prevalence of large-artery atherosclerosis (LAA) in our patients suggests the presence of uncontrolled hypertension, diabetes mellitus, smoking habit and dyslipidemia.展开更多
The Asian Stroke Criteria （ASC） was developed to detect etiology and topography of brain infarction. The ASC was designed by stroke neurologists and approved by the University of Alberta, Canada in 2003. In the firs...The Asian Stroke Criteria （ASC） was developed to detect etiology and topography of brain infarction. The ASC was designed by stroke neurologists and approved by the University of Alberta, Canada in 2003. In the first validation step, inter-rater reliability of ASC was evaluated. The inter-rater agreement, according to the ASC system, is much higher than other classifications with moderate inter-observer reliability. In the second validation step, ASC has been used successfully in Khorasan stroke registries.展开更多
Stroke etiology in young adults and older patient differs considerably, as well as epidemiology and clinical features vary according to geographical criteria. To improve clinical management and optimize diagnostic wor...Stroke etiology in young adults and older patient differs considerably, as well as epidemiology and clinical features vary according to geographical criteria. To improve clinical management and optimize diagnostic work-up of young adults with acute cerebrovascular events, we analyzed retrospectively data of 6-year stroke unit case series. In this hospital case series study, we enrolled 145 patients with acute cerebrovascular events aged 16 to 49, consecutively admitted to a Community Hospital Hub Stroke Unit. We studied risk factors for stroke, the distribution of acute cerebrovascular events, stroke subtype, length of stay and clinical outcome: 70% of patients were admitted for acute ischemic event (45 female-F, 57 male-M), 10.5% intracranial hemorrhages (5F, 10M), 2.7% subarachnoid hemorrhage (2F, 2M), 2% venous sinus thrombosis (3F), 14.5 for acute ischemic attack (12F, 9M). Among ischemic stroke patients, the etiology was as follows: atherothrombosis 29.4%, cardioembolism 19.6%, arterial dissection 13.7%, other determined causes 8.8%, lacunar stroke 5.8%, and undetermined causes 22.54%. 15% of ischemic young patients were treated with r-TPA. The majority of patients returned home at discharge, whereas 30% needed intensive rehabilitation programme to regain independence in the activity of daily living. Dedicated health care programme targeting prevention and optimizing treatment of acute cerebrovascular events in young adults are desirable to improve prognosis among this socioeconomically active age group.展开更多
291 patients were subjected to carotid endarterectomy from January 1985 to June 1992 in two Australian medical institutions. Of the 291 patients, perioperative stroke occurred in 22 (6.3%) after 347 operations (modera...291 patients were subjected to carotid endarterectomy from January 1985 to June 1992 in two Australian medical institutions. Of the 291 patients, perioperative stroke occurred in 22 (6.3%) after 347 operations (moderate 17 and severe 5). The 22 patients were studied with Doppler scan, angiography, reexploration and CT. Reexploration showed that 12 of 14 patients had thrombosis in the internal carotid artery at operation. The etiological factors for perioperative strokes included thrombosis at the operative sites in 14 patients (64%), cerebral embolism after operation in 4, clamping ischemia in 2, intracerebral hemorrhage in 1 and unknown cause in 1. Six patients (27%) recovered completely in 4 weeks, 10 (45%) had mild residual neurological deficits, 5 (23%) had moderate neurological deficits and 1 died 3 days after operation. Only 6 patients had permanent neurological deficits (6 / 347, 17%).展开更多
文摘Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been rarely reported. This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke （PALS）. Methods The medical records of 42 PAlS patients （age range： 9 months to 13 years） treated at Wuhan Children＇s Hospital between July 2007 and January 2011 were retrospectively reviewed. Infarction location was first determined by craniocerebral computed tomography and magnetic resonance （MR） imaging. The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography. Results The majority of the 42 PAlS cases （66.7%, n=28） were 〈3 years old （vs. 〉3 years old： 33.3%, n=14; P〈0.05）, but the male： female ratio was similar in both groups （P〉0.05）. The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium, but convulsions were more prevalent in children 〈3 years-old. Children〉3 years-old mainly experienced the limited physical activity symptoms, including hemiparalysis, aphasia, and ataxia. For all 42 cases, the most frequent etiologies were infections （38.1%, n=16）, iron deficiency anemia （16.7%, n=7）, and moyamoya syndrome （11.9%, n=5）. The predominant infarcts among all cases were middle cerebral artery （63.6%, n=21） and basal ganglia （64.3%, n=27）. Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms, but more research is required.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">The purpose of our study was to investigate etiologies of ischemic stroke in the neurology university clinic of CNHU-HKM, Cotonou. <strong>Method: </strong>It was a cross-sectional, prospective and analytical study carried out from 1<span style="white-space:nowrap;"><sup>st</sup></span> November 2014 to 31<span style="white-space:nowrap;"><sup>st</sup></span> August 2015 in the neurology university clinic of CNHU-HKM. We included all patients with stroke whose ischemic nature was confirmed through brain CT scan or magnetic resonance imaging. Data analysis was conducted with Census and Survey Processing System (CSPRO). We carried out bivariate then multivariate analysis in identifying associated factors. Threshold value is estimated at p < 0.05. <strong>Results:</strong> 104 ischemic stroke patients participated in the study, representing 59.4% of all types of stroke. Mean age was 61.9 ± 12.3 years [26 - 87 years] with 1.6 as sex ratio. Among vascular risk factors, hypertension accounted for 85.6% of stroke cases. 29.8% suffered from aphasia. Embolic heart diseases and atherosclerosis were predominant, in a proportion of 53% and 26% respectively. Atrial Fibrillation (AF) accounted for 82% of embolic heart diseases. <strong>Conclusion:</strong> Etiologic investigation of stroke is important and should be systematically carried out. This study enabled to corroborate atherosclerosis predominance in etiologic investigation of ischemic stroke. Patients’ outcome could be improved by promptly managing the etiology through adoption of appropriate treatment.</span> </div>
文摘<strong>Introduction:</strong> Stroke is the main cause of adult disability and the second most leading cause of death worldwide. The number of deaths due to stroke is 5.54 million worldwide. Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low and middle-income countries. <strong>Method:</strong> This was a prospective observational cross-sectional study conducted at Indoor, Outdoor, Stroke and Neuro-Intervention clinic of the Department of Neurology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh, from June-2019 to May-2020. A total of 220 ischemic stroke patients aged above 30 years confirmed by CT scan/MRI of brain. Data were collected with a pre-structured questionnaire from the patients, investigations reports and face-to-face interviews and analyzed using IBM SPSS software version 23.0. Proper consent was taken from the participants. The collected data were ANNOVA tests and association within the risk factors and the patterns of subtypes of ischemic stroke where P < 0.05 considered significant. <strong>Results:</strong> Among the 220 stroke patients, large-artery atherosclerosis (LAA), cardio-embolism (CE), small-vessel occlusion (SVO, stroke of other determined etiology (SODE) and stroke of undetermined etiology (SUDE) were being observed 84 (38.18%), 14 (6.36%), 63 (28.64%), 12 (5.45%) and 47 (18.18%). Eighty-Six (39.09%) prevalence of subtypes was found in rural areas whereas 134 (60.91%) were in urban areas. The significant risk factors are associated with the prevalence of various subtypes (p < 0.05). <strong>Conclusion:</strong> This study prevails the people of Bangladesh are vulnerable to various subtypes of ischemic stroke. The higher prevalence of large-artery atherosclerosis (LAA) in our patients suggests the presence of uncontrolled hypertension, diabetes mellitus, smoking habit and dyslipidemia.
文摘The Asian Stroke Criteria （ASC） was developed to detect etiology and topography of brain infarction. The ASC was designed by stroke neurologists and approved by the University of Alberta, Canada in 2003. In the first validation step, inter-rater reliability of ASC was evaluated. The inter-rater agreement, according to the ASC system, is much higher than other classifications with moderate inter-observer reliability. In the second validation step, ASC has been used successfully in Khorasan stroke registries.
文摘Stroke etiology in young adults and older patient differs considerably, as well as epidemiology and clinical features vary according to geographical criteria. To improve clinical management and optimize diagnostic work-up of young adults with acute cerebrovascular events, we analyzed retrospectively data of 6-year stroke unit case series. In this hospital case series study, we enrolled 145 patients with acute cerebrovascular events aged 16 to 49, consecutively admitted to a Community Hospital Hub Stroke Unit. We studied risk factors for stroke, the distribution of acute cerebrovascular events, stroke subtype, length of stay and clinical outcome: 70% of patients were admitted for acute ischemic event (45 female-F, 57 male-M), 10.5% intracranial hemorrhages (5F, 10M), 2.7% subarachnoid hemorrhage (2F, 2M), 2% venous sinus thrombosis (3F), 14.5 for acute ischemic attack (12F, 9M). Among ischemic stroke patients, the etiology was as follows: atherothrombosis 29.4%, cardioembolism 19.6%, arterial dissection 13.7%, other determined causes 8.8%, lacunar stroke 5.8%, and undetermined causes 22.54%. 15% of ischemic young patients were treated with r-TPA. The majority of patients returned home at discharge, whereas 30% needed intensive rehabilitation programme to regain independence in the activity of daily living. Dedicated health care programme targeting prevention and optimizing treatment of acute cerebrovascular events in young adults are desirable to improve prognosis among this socioeconomically active age group.
文摘291 patients were subjected to carotid endarterectomy from January 1985 to June 1992 in two Australian medical institutions. Of the 291 patients, perioperative stroke occurred in 22 (6.3%) after 347 operations (moderate 17 and severe 5). The 22 patients were studied with Doppler scan, angiography, reexploration and CT. Reexploration showed that 12 of 14 patients had thrombosis in the internal carotid artery at operation. The etiological factors for perioperative strokes included thrombosis at the operative sites in 14 patients (64%), cerebral embolism after operation in 4, clamping ischemia in 2, intracerebral hemorrhage in 1 and unknown cause in 1. Six patients (27%) recovered completely in 4 weeks, 10 (45%) had mild residual neurological deficits, 5 (23%) had moderate neurological deficits and 1 died 3 days after operation. Only 6 patients had permanent neurological deficits (6 / 347, 17%).
