Issue 3-85, 2018

Transient Cerebral Arteriopathy in Children and Adolescents, Features of Clinical Manifestations and Course

View article (Download PDF file)



Download XML file

1 Kessel A.Е., 1 Shchederkina I.О., 1,2 Koltunov I.E., 1 Drozdova I.М., 3 Guzeva V.I.

1 Morozov Сhild City Hospital, Center for treatment of cerebrovascular disease in children and adolescents
2 Russian University of Friendship of Peoples, Russia
3 «Saint Petersburg State Pediatric Medical University» Ministry of Health of Russia


ABSTRACT

The problem of a paediatric stroke has become relevant in recent decades. More than 50% of children with ischemicstroke are diagnosed with arteriopathy. The article presents observation of 61 patients with a confirmed diagnosis of arterialAI who underwent inpatient treatment at the Morozov City Child Clinic for the period from 2013 to 2018. 37 of them wereboys, the average age of children was 7.8 years. The follow-up period was 16 months to 5 years (an average of 2.6 years). In35 children from 61, according to neuroimaging, in the acute period, signs of arteriopathy were revealed. Of these, 24/31revealed signs of unilateral focal stenosis of the cerebral arteries that did not correspond to the clinical and radiological pictureof other types of arteriopathies, which were regarded in the framework of the focal cerebral arteriopathy. The analysisof clinical, laboratory and neuroimaging characteristics in groups of children with transient cerebral arteriopathy (TCAs) andwithout it was carried out. Progression of the neurological deficit and a less favorable outcome in children in the TCA groupwas noted. The need to isolate patients with arteriopathy is noted, which determines the tactics of dynamic observation andtreatment.


KEYWORDS: ischemic stroke, arteriopathy, stenosis of cerebral arteries


References:

  1. Giroud M, Lemesle M, Gouyon JB, Nivelon JL, Milan C, Dumas R. 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 ClinEpidemiol. 1995 Nov;48(11):1343-8
  2. Fullerton HJ, Wu YW, Zhao S, Johnston SC. Risk of stroke in children: ethnic and gender disparities. // Neurology. 2003 Jul 22;61(2)
  3. Schoenberg BS, Mellinger JF, Schoenberg DG. Cerebrovascular disease in infants and children: a study of incidence, clinical features, and survival. Neurology. 1978 Aug;28(8):763-8
  4. Haug V, Linder-Lucht M, Zieger B, Korinthenberg R, Mall V, Mader I. Unilateral venous thalamic infarction in a child mimicking a thalamic tumor. //J Child Neurol. 2009 Jan;24(1):105-9
  5. Ganesan V. et al. Investigation of risk factors in children with arterial ischemic stroke. // Ann. Neurol. 2003. Vol. 53, №2. P. 167-173.
  6. Roach E. S., Golomb M.R.; Adams R.; Iller J.; Daniels S.; deVeber G.; Ferriero D.; Jones B.V.; Kirkham F.J.; Scott R.M.; Smith M.R. Management of Stroke in Infants and Children A Scientific Statement From a Special Writing Group ofthe American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young //Stroke.2008;39:2644-2691.
  7. Wraige E., Pohl K., Ganesan V. A proposed classification for subtypes of arterial ischaemic stroke in children // Dev. Med. Child Neurol. 2005. Vol. 47, №4. P. 252-256.
  8. Bernard T.J. et al. Towards a Consensus-based Classification of Childhood Arterial Ischemic Stroke // Stroke. 2012. Vol. 43(2). P. 371-377.
  9. Calabrese L. Primary angiitis of the central nervous system: The penumbra of vasculitis // J. Rheumatol. 2001. Vol. 28, №3. P. 465-466.
  10. Sebire G. Transient cerebral arteriopathy in childhood // Lancet. 2006. Vol. 368, №9529. P. 8-10.
  11. Komarova I.B., Zy'kov V.P. Klassifikaciya Cascade Arterial'nogo Ishemicheskogo Insul'ta V Detskom Vozraste // Zhurnal nevrologii i psixiatrii. 2013. Vol. 5. P. 10-15.
  12. Amlie-Lefond C. Predictors of cerebral arteriopathy in children with arterial ischemic stroke;Results of the international pediatric stroke study // Circulation. 2009. Vol. 119, №10. P. 1417-1423.
  13. Lanni G, Catalucci A, Conti L, Di Sibio A, Paonessa A, Gallucci M. Pediatric stroke: clinical findings and radiological approach. //Stroke Res Treat. 2011;2011:172168
  14. Danchaivijitr N. et al. Evolution of cerebral arteriopathies in childhood arterial ischemic stroke // Ann. Neurol. 2006. Vol. 59, №4. P. 620-626.
  15. Sebire G, Fullerton H, Riou E, deVeber G Toward the definition of cerebral arteriopathies of childhood. CurrOpinPediatr. 2004 Dec 16(6):617-22.
  16. Zy'kov V.P., Komarova I.B., Ushakova L.V. Diagnostika i lechenie arterial'nogo ishemicheskogo insul'ta u detej v ostrom periode // Voprosy' sovremen-noj pediatrii. 2011. Vol. 10, №4. P. 70-77.
  17. Aviv R.I. et al. MR imaging and angiography of primary CNS vasculitis of childhood // Am. J. Neuroradiol. 2006. Vol. 27, №1. P. 192-199.
  18. Braun K.P.J. et al. Mode of onset predicts etiological diagnosis of arterial ischemic stroke in children // Stroke. 2007. Vol. 38, №2. P. 298-302.
  19. Chabrier S. et al. Transient Cerebral Arteriopathy: A Disorder Recognized by Serial Angiograms in Children With Stroke // J. Child Neurol. 1998. Vol. 13, №1. P. 27-32.
  20. Braun K. P. J., Bulder M. M. M., Chabrier S., Kirkham F. J., Uiterwaal C. S. P., Tardieu M., and Sebire G. The course and outcome of unilateral intracranial arteriopathy in 79 children with ischaemic stroke Brain. 2009 Feb;132(Pt 2):544-57
  21. Wintermark M, Hills NK, deVeber GA, Barkovich AJ, Elkind MS, Sear K, Zhu G, Leiva-Salinas C, Hou Q, Dowling MM, Bernard TJ, Friedman NR,Ichord RN, Fullerton HJ; VIPS Investigators. Arteriopathy diagnosis in childhood arterial ischemic stroke: results of the vascular effects of infection in pediatric stroke study. //Stroke. 2014 Dec 45(12):3597-605
  22. Yeon Je Young, М. Shin HyungJin. Nonprogressive Unilateral Intracranial Arteriopathy in Children with Arterial Ischemic Stroke J Korean Neurosurg Soc. 2015 Jun; 57(6): 401-407
  23. Mitchell S. V. Elkind, MD, MS, Nancy K. Hills, Carol A. Glaser, Warren D. Lo,CatherineAmlie-Lefond, NomazuluDlamini, Rachel Kneen,1 Eldad A. Hod,MaxWintermark, Gabrielle A. deVeber, Heather J. Fullerton.VIPS Investigator Herpesvirus Infections and Childhood Arterial Ischemic Stroke: Results of the VIPS //Circulation. 2016 Feb 23; 133(8): 732-741
  24. Federal'noe rukovodstvo po detskoj nevrologii/ pod red. V.I.Guzevoj. - M:OOO «MK»,2016. - 656 s.
  25. Kozlovskaya N.L. Trombofilicheskiesostoyaniya/N.L.Kozlovskaya//Klinicheskaya farmakologiya i terapiya. - 2003.T.12, №1. - S. 74-79
  26. Amlie-LefondC. ,Sebire G, Fullerton H.J. Recent developments in childhood arterial ischaemic stroke //Lancet Neurol. 2008 May;7(5): 425-35
  27. Elbers J, Halliday W, Hawkins C, Hutchinson C, Benseler SM. Brain biopsy in children with primary small-vessel central nervous system vasculitis. Ann Neurol. 2010 Nov;68(5):602-10
  28. Susanne M. Benseler, Earl Silverman, Richard I. Aviv, Rayfel Schneider, Derek Armstrong, Pascal N. Tyrrell and Gabrielle deVeberPrimary central nervous system vasculitis in children // Arthritis & Rheumatism Vol. 54, No. 4, April 2006, pp. 1291-1297



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©


This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.