Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications.

Brain and neurological disorders Pub Date : 2022-01-01 Epub Date: 2022-03-14
Abeer Dagra, Eric Williams, Sina Aghili-Mehrizi, Michael A Goutnik, Melanie Martinez, Ryan C Turner, Brandon Lucke-Wold
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Abstract

Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. This often results in life threatening conditions like herniation or clinical presentations including focal neurological deficits. In children, these events, although rare, have significant implications. Pediatric SAH is associated with better outcomes in the hospital setting and may even be prevented proactively by the recognition of potential risk factors. Specifically, better recognition of genetic predispositions, metastatic lesions, and infectious causes of aneurysms is important to understand their growth and prevent hemorrhagic events. This review highlights the causes of pediatric SAH, reviews the models of current understanding of this etiology, and discusses the current treatment schema to provide a succinct summary and highlight gaps in current knowledge. This may lead to future investigations aimed at further improving prevention strategies, patient care, and patient outcomes.

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小儿蛛网膜下腔出血:罕见事件,意义重大。
动脉瘤破裂是蛛网膜下腔出血(SAH)的主要原因,会导致血液在蛛网膜和桥膜之间积聚,从而增加颅内压。这通常会导致疝气等危及生命的情况或局灶性神经功能缺损等临床表现。在儿童中,这些事件虽然罕见,但却具有重大影响。小儿 SAH 在医院的治疗效果较好,甚至可以通过识别潜在的风险因素来主动预防。具体来说,更好地识别动脉瘤的遗传倾向、转移性病变和感染性原因对于了解其生长和预防出血事件非常重要。这篇综述强调了小儿 SAH 的病因,回顾了目前对这一病因的理解模式,并讨论了目前的治疗方案,以提供一个简洁的总结,并强调目前知识中的差距。这可能会促使未来的研究旨在进一步改善预防策略、患者护理和患者预后。
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