Acute StrokeTreatment in Children: Are Adult Guidelines Applicable?

IF 2 4区 医学 Q1 Medicine Current Treatment Options in Neurology Pub Date : 2022-01-01 DOI:10.1007/s11940-022-00707-6
Sudeepta Dandapat, Waldo R Guerrero, Santiago Ortega-Gutierrez
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Abstract

Purpose of this review: This article provides an overview into acute treatments in stroke which are widely studied and available for adults and their applicability in the pediatric population.

Recent findings: Arterial ischemic stroke is an important cause of morbidity and mortality in the pediatric population. Neurological deficits and etiologies are age-dependent and more challenging to diagnose than in the adult population. Advancements in imaging and treatment modalities including increased treatment windows in acute stroke have led to improvement in the diagnosis and management of pediatric arterial ischemic disease. Accordingly, hyperacute treatments, such as endovascular therapy, are becoming increasingly available in an attempt to improve outcomes in children.

Summary: Significant scientific and technological advances have transformed the hyperacute treatment of stroke in the recent years, allowing for improvement in the diagnosis and treatment of cerebrovascular pathologies in children. Optimization in the approach, and validation of existing stroke pathways/protocols is expected to further advance acute stroke therapy in pediatric patient care. Given that the lifelong individual, family, and societal burden of acute stroke is likely to be greater than in adults because infants and children surviving stroke live more years with disability, we must be knowledgeable about this pathology and the medical and therapeutic options available for this unique population as detailed in this review.

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儿童急性卒中治疗:成人指南是否适用?
本综述的目的:本文综述了广泛研究和适用于成人的脑卒中急性治疗及其在儿科人群中的适用性。最近发现:动脉缺血性脑卒中是儿童发病和死亡的重要原因。神经功能缺陷和病因与年龄有关,比成人更难以诊断。影像学和治疗方式的进步,包括急性卒中治疗窗口的增加,导致了儿童动脉缺血性疾病的诊断和管理的改善。因此,超急性治疗,如血管内治疗,越来越多地用于改善儿童的预后。摘要:近年来,重大的科学技术进步已经改变了卒中的超急性治疗,使得儿童脑血管疾病的诊断和治疗得到改善。方法的优化和现有卒中途径/方案的验证有望进一步推进儿科患者护理中的急性卒中治疗。鉴于急性中风的终生个人、家庭和社会负担可能比成人更大,因为婴儿和儿童在中风后会残疾更长时间,我们必须了解这种病理以及本综述中详述的针对这一独特人群的医疗和治疗选择。
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来源期刊
CiteScore
4.00
自引率
0.00%
发文量
40
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of neurology. By presenting clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to the treatment of neurologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as epilepsy, headache, neurologic ophthalmology and otology, neuromuscular disorders, psychiatric manifestations of neurologic disease, and sleep disorders. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known neurologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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