Ischaemic stroke in children: diagnostic and therapeutic specificity]

Although more common in older adults, stroke occurs in neonates, infants and children as well, resulting in significant morbidity and mortality.The incidence of childhood ischemic stroke exceeds 3.3 in 100,000 children per year. Stroke is one of the top ten causes of death in children.Children's strokes are often caused by birth defects, injections (e.g. meningitis, encephalitis), trauma, and blood disorders. Risk factors for stroke are recognized in more than 75% of children. The most common cause of stroke in children is probably congenital or acquired heart disease.Children often experience different symptoms of stroke to adults. These can include seizures, headache and fever. However, many of" the symptoms of stroke in children are similar to those experienced by adults (paralysis, speech and visual impairment). DIAGNOSTIC EVALUATIONS: Urgent neuroimaging is important for confirming the diagnosis of stroke. It is necessary for clinicians to conduct a thorough investigation for possible cardiac, vascular, and hematologic risk factors in all patients.The appropriate choices for in-hospital acute treatment and secondary preventative strategies, including aspirin and anticoagulants, are controversial. The recommendations for children are based mainly upon extrapolation from studies involving adults, and the clinical experience of experts, as reflected in consensus guidelines.Advanced forms of thrombolytic and neuroprotective agents may become more readily available to paediatric stroke patients when both the general public and medical staff become more aware of this disorder.