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目的总结儿童动脉缺血性卒中(AIS)的临床特点、病因及危险因素。方法回顾性分析2003年1月-2011年3月在重庆医科大学附属儿童医院住院治疗的AIS患儿资料,采用SPSS 17.0软件进行分析,描述患儿年龄、性别分布等基本情况、相关病因及危险因素,并分析头部轻微外伤与基底核钙化是否存在相关性。结果本组患儿中,男31例,女27例;年龄2个月～13岁,平均3岁10个月。常见神经系统表现依次为肢体偏瘫52例(92.8%),中枢性面瘫34例(58.6%),运动性失语16例(27.6%),头痛、呕吐11例(19.0%),意识障碍8例(13.8%),惊厥7例(12.1%)。40例进行血管影像学检查,其中33例异常,左侧大脑中动脉受累最常见(19例,47.5%)。常见病因为轻微头部外伤(26例,44.8%)、烟雾病(8例,13.8%)和颅内感染(5例,8.6%),18例(31.0%)患儿为多病因共存,6例(10.3%)患儿未找到任何病因或危险因素,22例(37.9%)患儿有呼吸道感染。结论儿童AIS发病高峰人群为幼儿及学龄前期儿童,最常见的神经功能障碍为肢体偏瘫,神经影像学显示左侧大脑中动脉狭窄或中断最常见,常见病因为轻微头部外伤、烟雾病及颅内感染,较多患儿病前或病程中有上呼吸道感染。积极预防感染、减少头部外伤,对突发偏瘫患儿早期行头颅影像和血管检查将有利于AIS的预防和早期诊断。
Objective To summarize the clinical features, etiology and risk factors of arterial ischemic stroke (AIS) in children. Methods A retrospective analysis was conducted on the data of hospitalized children with AIS at Children’s Hospital of Chongqing Medical University from January 2003 to March 2011. The data were analyzed by SPSS 17.0 software to describe the children’s age and sex distribution and other related etiologies and risks Factors, and analysis of head trauma and basal nucleus calcification is related to the existence. Results This group of children, 31 males and 27 females; aged 2 months to 13 years, an average of 3 years and 10 months. Common neurological manifestations were limb hemiplegia in 52 cases (92.8%), central facial paralysis in 34 cases (58.6%), exercise aphasia in 16 cases (27.6%), headache and vomiting in 11 cases (19.0%), disturbance of consciousness in 8 cases 13.8%), convulsions in 7 cases (12.1%). Twenty-four patients underwent angiography, of which 33 were abnormal and the left middle cerebral artery involvement was the most common (19, 47.5%). The common causes were multiple head and neck injuries (26 cases, 44.8%), moyamoya disease (8 cases, 13.8%) and intracranial infection (5 cases, 8.6%) and 18 cases (31.0% Cases (10.3%) did not find any cause or risk factors in children, 22 cases (37.9%) children with respiratory tract infection. Conclusions The highest incidence of childhood AIS was in infants and preschool children. The most common neurological dysfunction was limb hemiplegia. Neuroimaging showed that the left middle cerebral artery stenosis or disruption was the most common. The common causes were minor head trauma, moyamoya disease and craniofacial Infection, more children with the upper respiratory tract infection before or during the course of disease. Actively prevent infection and reduce head trauma, early skull imaging and vascular examination in children with sudden hemiplegia will be conducive to the prevention and early diagnosis of AIS.