Patologia vasculară sistemică cu risc pentru accidentul vascular cerebral ischemic la copil

Abstract

Summary. Stroke is defined as a sudden loss of brain function caused by a decreased cerebral blood flow in affected areas. Stroke is a rare condition in pediatric populations with significant morbidity and an estimated incidence of between 1.3-13/100.000 patients. Pediatric stroke includes 3 different subtypes: acute ischemic stroke, hemorrhagic stroke, and cerebral venous sinus thrombosis. The etiology of stroke is multifactorial and includes congenital heart disease considered the major risk factor responsible for nearly 30% of pediatric strokes, thrombotic states, sepsis, vasculitis, meningitis. Systemic vascular disorders leading to pediatric stroke include volume depletion or systemic hypotension and hypernatremic dehydration. Hypernatremic dehydration is common in children, especially during pathological conditions such as infectious gastroenteritis, increase free water loss, inadequate fluid intake inappropriately reconstituted infant formula, and inadequate breastfeeding. Neurological sequelae of the cerebral insult consisted of generalized seizures, bilateral motor deficit, aphasia, and cognitive deficits. Hemorrhagic encephalopathy is a recognized complication of hypernatremia attributed to excessively rapid rehydration and correction of serum osmolarity. Several studies suggest that inflammation and infectious mechanisms may be involved in the pathogenesis of arterial ischemic stroke in children. The profile of inflammatory biomarkers in ischemic arterial stroke is essential in diagnostic evaluation and therapeutic involvement.