Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Pädiatrie & Pädologie 5/2020

17.09.2020 | Originalien

„Childhood stroke“

Was macht den Schlaganfall beim Kind besonders?

verfasst von: PD Dr. med. L. Gerstl, M. V. Bonfert, T. Nicolai, M. Dieterich, C. Adamczyk, F. Heinen, M. Olivieri, M. Steinlin

Erschienen in: Pädiatrie & Pädologie | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten
share
TEILEN

Zusammenfassung

Der arteriell ischämische Schlaganfall des Kindes – „childhood stroke“ – unterscheidet sich in wesentlichen Aspekten vom Schlaganfall des Erwachsenen. Er ist selten, bei Laien und Ärzten oft wenig bekannt und wird, aufgrund einer Fülle prozentual wahrscheinlicherer Differenzialdiagnosen („stroke mimics“) und in der Fläche noch wenig etablierter Versorgungsstrukturen, häufig erst jenseits der hyperakuten Phase diagnostiziert. Die möglichen Therapien im Kindesalter sind zumeist off-label. Erfahrungen zu den in der Erwachsenenneurologie etablierten Akuttherapien der Thrombolyse und mechanischen Thrombektomie sind in der Pädiatrie noch begrenzt und basieren auf Fallberichten/-serien. Die ätiologische Abklärung ist aufgrund der Fülle der zu bedenkenden Risikofaktoren aufwendig. Bei einem Großteil der Patienten können mindestens zwei Risikofaktoren nachgewiesen werden. Das individuelle Risikoprofil eines jeden Patienten ist entscheidend für die Akuttherapie und Sekundärprophylaxe und beeinflusst das individuelle Outcome. Für die Integration des Kindes in sein schulisches, später berufliches und soziales Umfeld sind neben dem klinisch neurologischen Outcome auch die Auswirkungen des Schlaganfalls auf Kognition und Verhalten entscheidend.
Literatur
1.
Zurück zum Zitat Amlie-Lefond C, Gilden D (2016) Varicella zoster virus: a common cause of stroke in children and adults. J Stroke Cerebrovasc Dis 25:1561–1569 PubMedPubMedCentral Amlie-Lefond C, Gilden D (2016) Varicella zoster virus: a common cause of stroke in children and adults. J Stroke Cerebrovasc Dis 25:1561–1569 PubMedPubMedCentral
2.
Zurück zum Zitat Barnes C, Deveber G (2006) Prothrombotic abnormalities in childhood ischaemic stroke. Thromb Res 118:67–74 PubMed Barnes C, Deveber G (2006) Prothrombotic abnormalities in childhood ischaemic stroke. Thromb Res 118:67–74 PubMed
3.
Zurück zum Zitat Braun KP, Bulder MM, Chabrier S et al (2009) The course and outcome of unilateral intracranial arteriopathy in 79 children with ischaemic stroke. Brain 132:544–557 PubMed Braun KP, Bulder MM, Chabrier S et al (2009) The course and outcome of unilateral intracranial arteriopathy in 79 children with ischaemic stroke. Brain 132:544–557 PubMed
4.
Zurück zum Zitat Breitweg I, Stulpnagel CV, Pieper T et al (2017) Early seizures predict the development of epilepsy in children and adolescents with stroke. Eur J Paediatr Neurol 21:465–467 PubMed Breitweg I, Stulpnagel CV, Pieper T et al (2017) Early seizures predict the development of epilepsy in children and adolescents with stroke. Eur J Paediatr Neurol 21:465–467 PubMed
5.
Zurück zum Zitat Buompadre MC, Andres K, Slater LA et al (2017) Thrombectomy for acute stroke in childhood: a case report, literature review, and recommendations. Pediatr Neurol 66:21–27 PubMed Buompadre MC, Andres K, Slater LA et al (2017) Thrombectomy for acute stroke in childhood: a case report, literature review, and recommendations. Pediatr Neurol 66:21–27 PubMed
7.
Zurück zum Zitat Cobb MIH, Laarakker AS, Gonzalez LF et al (2017) Endovascular therapies for acute ischemic stroke in children. Stroke 48:2026–2030 PubMed Cobb MIH, Laarakker AS, Gonzalez LF et al (2017) Endovascular therapies for acute ischemic stroke in children. Stroke 48:2026–2030 PubMed
8.
Zurück zum Zitat Coffino SW, Fryer RH (2017) Reversible cerebral vasoconstriction syndrome in pediatrics: a case series and review. J Child Neurol 32:614–623 PubMed Coffino SW, Fryer RH (2017) Reversible cerebral vasoconstriction syndrome in pediatrics: a case series and review. J Child Neurol 32:614–623 PubMed
9.
Zurück zum Zitat Daseking M, Petermann F, Simonis A (2008) Behavioral disorders and psycho-social outcome after stroke in children. Fortschr Neurol Psychiatr 76:662–671 PubMed Daseking M, Petermann F, Simonis A (2008) Behavioral disorders and psycho-social outcome after stroke in children. Fortschr Neurol Psychiatr 76:662–671 PubMed
10.
Zurück zum Zitat Deveber G (2002) Stroke and the child’s brain: an overview of epidemiology, syndromes and risk factors. Curr Opin Neurol 15:133–138 PubMed Deveber G (2002) Stroke and the child’s brain: an overview of epidemiology, syndromes and risk factors. Curr Opin Neurol 15:133–138 PubMed
11.
Zurück zum Zitat Deveber G, Kirkham F (2008) Guidelines for the treatment and prevention of stroke in children. Lancet Neurol 7:983–985 PubMed Deveber G, Kirkham F (2008) Guidelines for the treatment and prevention of stroke in children. Lancet Neurol 7:983–985 PubMed
12.
Zurück zum Zitat Dlamini N, Freeman JL, Mackay MT et al (2011) Intracranial dissection mimicking transient cerebral arteriopathy in childhood arterial ischemic stroke. J Child Neurol 26:1203–1206 PubMed Dlamini N, Freeman JL, Mackay MT et al (2011) Intracranial dissection mimicking transient cerebral arteriopathy in childhood arterial ischemic stroke. J Child Neurol 26:1203–1206 PubMed
13.
Zurück zum Zitat Dowling MM, Hynan LS, Lo W et al (2013) International paediatric stroke study: stroke associated with cardiac disorders. Int J Stroke 8(Suppl A100):39–44 PubMed Dowling MM, Hynan LS, Lo W et al (2013) International paediatric stroke study: stroke associated with cardiac disorders. Int J Stroke 8(Suppl A100):39–44 PubMed
14.
Zurück zum Zitat Dowling MM, Ikemba CM (2011) Intracardiac shunting and stroke in children: a systematic review. J Child Neurol 26:72–82 PubMedPubMedCentral Dowling MM, Ikemba CM (2011) Intracardiac shunting and stroke in children: a systematic review. J Child Neurol 26:72–82 PubMedPubMedCentral
15.
Zurück zum Zitat Elkind MS, Hills NK, Glaser CA et al (2016) Herpesvirus infections and childhood arterial ischemic stroke: results of the VIPS study. Circulation 133:732–741 PubMedPubMedCentral Elkind MS, Hills NK, Glaser CA et al (2016) Herpesvirus infections and childhood arterial ischemic stroke: results of the VIPS study. Circulation 133:732–741 PubMedPubMedCentral
16.
Zurück zum Zitat Fox CK, Glass HC, Sidney S et al (2013) Acute seizures predict epilepsy after childhood stroke. Ann Neurol 74:249–256 PubMedPubMedCentral Fox CK, Glass HC, Sidney S et al (2013) Acute seizures predict epilepsy after childhood stroke. Ann Neurol 74:249–256 PubMedPubMedCentral
17.
Zurück zum Zitat Fullerton HJ, Hills NK, Elkind MS et al (2015) Infection, vaccination, and childhood arterial ischemic stroke: results of the VIPS study. Neurology 85:1459–1466 PubMedPubMedCentral Fullerton HJ, Hills NK, Elkind MS et al (2015) Infection, vaccination, and childhood arterial ischemic stroke: results of the VIPS study. Neurology 85:1459–1466 PubMedPubMedCentral
18.
Zurück zum Zitat Fullerton HJ, Wu YW, Zhao S et al (2003) Risk of stroke in children: ethnic and gender disparities. Neurology 61:189–194 PubMed Fullerton HJ, Wu YW, Zhao S et al (2003) Risk of stroke in children: ethnic and gender disparities. Neurology 61:189–194 PubMed
19.
Zurück zum Zitat Gerstl L, Heinen F, Borggraefe I et al (2017) Paediatric stroke – a paediatric neurological emergency. Symptoms, diagnostic strategies and management. Monatsschr Kinderheilkd 165:408–415 Gerstl L, Heinen F, Borggraefe I et al (2017) Paediatric stroke – a paediatric neurological emergency. Symptoms, diagnostic strategies and management. Monatsschr Kinderheilkd 165:408–415
20.
Zurück zum Zitat Gerstl L, Olivieri M, Heinen F et al (2016) Successful mechanical thrombectomy in a three-year-old boy with cardioembolic occlusion of both the basilar artery and the left middle cerebral artery. Eur J Paediatr Neurol 20:962–965 PubMed Gerstl L, Olivieri M, Heinen F et al (2016) Successful mechanical thrombectomy in a three-year-old boy with cardioembolic occlusion of both the basilar artery and the left middle cerebral artery. Eur J Paediatr Neurol 20:962–965 PubMed
21.
Zurück zum Zitat Giroud M, Lemesle M, Gouyon JB et al (1995) Cerebrovascular disease in children under 16 years of age in the city of Dijon, France: a study of incidence and clinical features from 1985 to 1993. J Clin Epidemiol 48:1343–1348 PubMed Giroud M, Lemesle M, Gouyon JB et al (1995) Cerebrovascular disease in children under 16 years of age in the city of Dijon, France: a study of incidence and clinical features from 1985 to 1993. J Clin Epidemiol 48:1343–1348 PubMed
22.
Zurück zum Zitat Goldenberg NA, Bernard TJ, Fullerton HJ et al (2009) Antithrombotic treatments, outcomes, and prognostic factors in acute childhood-onset arterial ischaemic stroke: a multicentre, observational, cohort study. Lancet Neurol 8:1120–1127 PubMed Goldenberg NA, Bernard TJ, Fullerton HJ et al (2009) Antithrombotic treatments, outcomes, and prognostic factors in acute childhood-onset arterial ischaemic stroke: a multicentre, observational, cohort study. Lancet Neurol 8:1120–1127 PubMed
23.
Zurück zum Zitat Golomb MR, Fullerton HJ, Nowak-Gottl U et al (2009) Male predominance in childhood ischemic stroke: findings from the international pediatric stroke study. Stroke 40:52–57 PubMed Golomb MR, Fullerton HJ, Nowak-Gottl U et al (2009) Male predominance in childhood ischemic stroke: findings from the international pediatric stroke study. Stroke 40:52–57 PubMed
24.
Zurück zum Zitat Homma S, Sacco RL (2005) Patent foramen ovale and stroke. Circulation 112:1063–1072 PubMed Homma S, Sacco RL (2005) Patent foramen ovale and stroke. Circulation 112:1063–1072 PubMed
25.
Zurück zum Zitat Hsu CJ, Weng WC, Peng SS et al (2014) Early-onset seizures are correlated with late-onset seizures in children with arterial ischemic stroke. Stroke 45:1161–1163 PubMed Hsu CJ, Weng WC, Peng SS et al (2014) Early-onset seizures are correlated with late-onset seizures in children with arterial ischemic stroke. Stroke 45:1161–1163 PubMed
26.
Zurück zum Zitat Jacomb I, Porter M, Brunsdon R et al (2016) Cognitive outcomes of pediatric stroke. Child Neuropsychol 14:1–17 Jacomb I, Porter M, Brunsdon R et al (2016) Cognitive outcomes of pediatric stroke. Child Neuropsychol 14:1–17
27.
Zurück zum Zitat Kenet G, Lutkhoff LK, Albisetti M et al (2010) Impact of thrombophilia on risk of arterial ischemic stroke or cerebral sinovenous thrombosis in neonates and children: a systematic review and meta-analysis of observational studies. Circulation 121:1838–1847 PubMed Kenet G, Lutkhoff LK, Albisetti M et al (2010) Impact of thrombophilia on risk of arterial ischemic stroke or cerebral sinovenous thrombosis in neonates and children: a systematic review and meta-analysis of observational studies. Circulation 121:1838–1847 PubMed
28.
Zurück zum Zitat Khan R, Chan AK, Mondal TK et al (2016) Patent foramen ovale and stroke in childhood: a systematic review of the literature. Eur J Paediatr Neurol 20:500–511 PubMed Khan R, Chan AK, Mondal TK et al (2016) Patent foramen ovale and stroke in childhood: a systematic review of the literature. Eur J Paediatr Neurol 20:500–511 PubMed
30.
Zurück zum Zitat Kirton A, Deveber G (2015) Paediatric stroke: pressing issues and promising directions. Lancet Neurol 14:92–102 PubMed Kirton A, Deveber G (2015) Paediatric stroke: pressing issues and promising directions. Lancet Neurol 14:92–102 PubMed
31.
Zurück zum Zitat Lanthier S, Armstrong D, Domi T et al (2005) Post-varicella arteriopathy of childhood: natural history of vascular stenosis. Neurology 64:660–663 PubMed Lanthier S, Armstrong D, Domi T et al (2005) Post-varicella arteriopathy of childhood: natural history of vascular stenosis. Neurology 64:660–663 PubMed
32.
Zurück zum Zitat Lanthier S, Carmant L, David M et al (2000) Stroke in children: The coexistence of multiple risk factors predicts poor outcome. Neurology 54:371–378 PubMed Lanthier S, Carmant L, David M et al (2000) Stroke in children: The coexistence of multiple risk factors predicts poor outcome. Neurology 54:371–378 PubMed
33.
Zurück zum Zitat Lynch JK, Hirtz DG, Deveber G et al (2002) Report of the National Institute of Neurological Disorders and Stroke workshop on perinatal and childhood stroke. Pediatrics 109:116–123 PubMed Lynch JK, Hirtz DG, Deveber G et al (2002) Report of the National Institute of Neurological Disorders and Stroke workshop on perinatal and childhood stroke. Pediatrics 109:116–123 PubMed
34.
Zurück zum Zitat Mackay MT, Chua ZK, Lee M et al (2014) Stroke and nonstroke brain attacks in children. Neurology 82:1434–1440 PubMed Mackay MT, Chua ZK, Lee M et al (2014) Stroke and nonstroke brain attacks in children. Neurology 82:1434–1440 PubMed
35.
Zurück zum Zitat Mackay MT, Monagle P, Babl FE (2016) Brain attacks and stroke in children. J Paediatr Child Health 52:158–163 PubMed Mackay MT, Monagle P, Babl FE (2016) Brain attacks and stroke in children. J Paediatr Child Health 52:158–163 PubMed
36.
Zurück zum Zitat Mackay MT, Wiznitzer M, Benedict SL et al (2011) Arterial ischemic stroke risk factors: the International Pediatric Stroke Study. Ann Neurol 69:130–140 PubMed Mackay MT, Wiznitzer M, Benedict SL et al (2011) Arterial ischemic stroke risk factors: the International Pediatric Stroke Study. Ann Neurol 69:130–140 PubMed
38.
Zurück zum Zitat Mallick AA, Ganesan V, Kirkham FJ et al (2015) Diagnostic delays in paediatric stroke. J Neurol Neurosurg Psychiatr 86:917–921 Mallick AA, Ganesan V, Kirkham FJ et al (2015) Diagnostic delays in paediatric stroke. J Neurol Neurosurg Psychiatr 86:917–921
39.
Zurück zum Zitat Mallick AA, Ganesan V, Kirkham FJ et al (2014) Childhood arterial ischaemic stroke incidence, presenting features, and risk factors: a prospective population-based study. Lancet Neurol 13:35–43 PubMed Mallick AA, Ganesan V, Kirkham FJ et al (2014) Childhood arterial ischaemic stroke incidence, presenting features, and risk factors: a prospective population-based study. Lancet Neurol 13:35–43 PubMed
40.
Zurück zum Zitat Martin C, Von Elm E, El-Koussy M et al (2011) Delayed diagnosis of acute ischemic stroke in children – a registry-based study in Switzerland. Swiss Med Wkly 141:w13281 PubMed Martin C, Von Elm E, El-Koussy M et al (2011) Delayed diagnosis of acute ischemic stroke in children – a registry-based study in Switzerland. Swiss Med Wkly 141:w13281 PubMed
41.
Zurück zum Zitat Mirsky DM, Beslow LA, Amlie-Lefond C et al (2017) Pathways for neuroimaging of childhood stroke. Pediatr Neurol 69:11–23 PubMed Mirsky DM, Beslow LA, Amlie-Lefond C et al (2017) Pathways for neuroimaging of childhood stroke. Pediatr Neurol 69:11–23 PubMed
42.
Zurück zum Zitat Monagle P, Chan AK, Goldenberg NA et al (2012) Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e737S–e801S PubMedPubMedCentral Monagle P, Chan AK, Goldenberg NA et al (2012) Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e737S–e801S PubMedPubMedCentral
43.
Zurück zum Zitat Munot P, Crow YJ, Ganesan V (2011) Paediatric stroke: genetic insights into disease mechanisms and treatment targets. Lancet Neurol 10:264–274 PubMed Munot P, Crow YJ, Ganesan V (2011) Paediatric stroke: genetic insights into disease mechanisms and treatment targets. Lancet Neurol 10:264–274 PubMed
44.
Zurück zum Zitat Nestoridi E, Buonanno FS, Jones RM et al (2002) Arterial ischemic stroke in childhood: the role of plasma-phase risk factors. Curr Opin Neurol 15:139–144 PubMed Nestoridi E, Buonanno FS, Jones RM et al (2002) Arterial ischemic stroke in childhood: the role of plasma-phase risk factors. Curr Opin Neurol 15:139–144 PubMed
45.
Zurück zum Zitat Pandey AS, Hill E, Al-Holou WN et al (2015) Management of pediatric craniocervical arterial dissections. Childs Nerv Syst 31:101–107 PubMed Pandey AS, Hill E, Al-Holou WN et al (2015) Management of pediatric craniocervical arterial dissections. Childs Nerv Syst 31:101–107 PubMed
46.
Zurück zum Zitat Rafay MF, Armstrong D, Deveber G et al (2006) Craniocervical arterial dissection in children: clinical and radiographic presentation and outcome. J Child Neurol 21:8–16 PubMed Rafay MF, Armstrong D, Deveber G et al (2006) Craniocervical arterial dissection in children: clinical and radiographic presentation and outcome. J Child Neurol 21:8–16 PubMed
47.
Zurück zum Zitat Rafay MF, Pontigon AM, Chiang J et al (2009) Delay to diagnosis in acute pediatric arterial ischemic stroke. Stroke 40:58–64 PubMed Rafay MF, Pontigon AM, Chiang J et al (2009) Delay to diagnosis in acute pediatric arterial ischemic stroke. Stroke 40:58–64 PubMed
49.
51.
Zurück zum Zitat Savastano L, Gemmete JJ, Pandey AS et al (2015) Acute ischemic stroke in a child due to basilar artery occlusion treated successfully with a stent retriever. BMJ Case Rep 8(8):e33 Savastano L, Gemmete JJ, Pandey AS et al (2015) Acute ischemic stroke in a child due to basilar artery occlusion treated successfully with a stent retriever. BMJ Case Rep 8(8):e33
52.
Zurück zum Zitat Saver JL, Goyal M, Van Der Lugt A et al (2016) Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA 316:1279–1288 PubMed Saver JL, Goyal M, Van Der Lugt A et al (2016) Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA 316:1279–1288 PubMed
53.
Zurück zum Zitat Steinlin M (2012) A clinical approach to arterial ischemic childhood stroke: increasing knowledge over the last decade. Neuropediatrics 43:1–9 PubMed Steinlin M (2012) A clinical approach to arterial ischemic childhood stroke: increasing knowledge over the last decade. Neuropediatrics 43:1–9 PubMed
55.
Zurück zum Zitat Steinlin M, Mackay MT (2015) Emergency management of ischemic stroke in children. Curr Treat Options Neurol 17:349 PubMed Steinlin M, Mackay MT (2015) Emergency management of ischemic stroke in children. Curr Treat Options Neurol 17:349 PubMed
56.
Zurück zum Zitat Steinlin M, Pfister I, Pavlovic J et al (2005) The first three years of the Swiss Neuropaediatric Stroke Registry (SNPSR): a population-based study of incidence, symptoms and risk factors. Neuropediatrics 36:90–97 PubMed Steinlin M, Pfister I, Pavlovic J et al (2005) The first three years of the Swiss Neuropaediatric Stroke Registry (SNPSR): a population-based study of incidence, symptoms and risk factors. Neuropediatrics 36:90–97 PubMed
57.
Zurück zum Zitat Stence NV, Pabst LL, Hollatz AL et al (2017) Predicting progression of intracranial arteriopathies in childhood stroke with vessel wall imaging. Stroke 48:2274–2277 PubMed Stence NV, Pabst LL, Hollatz AL et al (2017) Predicting progression of intracranial arteriopathies in childhood stroke with vessel wall imaging. Stroke 48:2274–2277 PubMed
58.
Zurück zum Zitat Strater R, Becker S, Von Eckardstein A et al (2002) Prospective assessment of risk factors for recurrent stroke during childhood – a 5‑year follow-up study. Lancet 360:1540–1545 PubMed Strater R, Becker S, Von Eckardstein A et al (2002) Prospective assessment of risk factors for recurrent stroke during childhood – a 5‑year follow-up study. Lancet 360:1540–1545 PubMed
59.
Zurück zum Zitat Studer M, Boltshauser E, Capone Mori A et al (2014) Factors affecting cognitive outcome in early pediatric stroke. Neurology 82:784–792 PubMed Studer M, Boltshauser E, Capone Mori A et al (2014) Factors affecting cognitive outcome in early pediatric stroke. Neurology 82:784–792 PubMed
60.
Zurück zum Zitat Werho DK, Pasquali SK, Yu S et al (2015) Epidemiology of stroke in pediatric cardiac surgical patients supported with extracorporeal membrane oxygenation. Ann Thorac Surg 100:1751–1757 PubMedPubMedCentral Werho DK, Pasquali SK, Yu S et al (2015) Epidemiology of stroke in pediatric cardiac surgical patients supported with extracorporeal membrane oxygenation. Ann Thorac Surg 100:1751–1757 PubMedPubMedCentral
61.
Zurück zum Zitat Wintermark M, Hills NK, Deveber GA et al (2014) Arteriopathy diagnosis in childhood arterial ischemic stroke: results of the vascular effects of infection in pediatric stroke study. Stroke 45:3597–3605 PubMedPubMedCentral Wintermark M, Hills NK, Deveber GA et al (2014) Arteriopathy diagnosis in childhood arterial ischemic stroke: results of the vascular effects of infection in pediatric stroke study. Stroke 45:3597–3605 PubMedPubMedCentral
62.
Zurück zum Zitat Yock-Corrales A, Babl FE, Mosley IT et al (2011) Can the FAST and ROSIER adult stroke recognition tools be applied to confirmed childhood arterial ischemic stroke? BMC Pediatr 11:93 PubMedPubMedCentral Yock-Corrales A, Babl FE, Mosley IT et al (2011) Can the FAST and ROSIER adult stroke recognition tools be applied to confirmed childhood arterial ischemic stroke? BMC Pediatr 11:93 PubMedPubMedCentral
Metadaten
Titel
„Childhood stroke“
Was macht den Schlaganfall beim Kind besonders?
verfasst von
PD Dr. med. L. Gerstl
M. V. Bonfert
T. Nicolai
M. Dieterich
C. Adamczyk
F. Heinen
M. Olivieri
M. Steinlin
Publikationsdatum
17.09.2020
Verlag
Springer Vienna
Erschienen in
Pädiatrie & Pädologie / Ausgabe 5/2020
Print ISSN: 0030-9338
Elektronische ISSN: 1613-7558
DOI
https://doi.org/10.1007/s00608-020-00832-y