Arterial ischemic stroke (AIS) in childhood is reported to occur more frequently in boys, which may lead to the assumption that the prevalence of post-stroke deficits is sex related. The present study aimed to evaluate sex-related differences in functional outcomes (hemiparesis, seizures, aphasia, and motor disturbances other than hemiparesis) in pediatric patients with AIS. A total of 89 children (52 boys and 37 girls; mean age at stroke onset: 8.4 ± 5.6 years) were evaluated retrospectively based on data from medical records. The patients were divided into subgroups according to age (i.e., infants and toddlers, children, and adolescents), stroke subtype (i.e., lacunar anterior circulation infarct (LACI), total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI)) and stroke location (i.e., anterior stroke, posterior stroke). Significant differences in the prevalence of stroke subtypes between girls and boys were observed (p = 0.034). POCI stroke were found to be more frequent in boys than in girls (OR = 8.57 95%CI 1.05–70.23, p = 0.023). Males predominated in the total group and in all analyzed age subgroups. The proportions of boys within the subgroups according to stroke subtype were extremely high for the POCI and TACI stroke subgroups. On the other hand, girls predominated in the LACI stroke subgroup. Frequency of central type facial nerve palsy and other symptoms of AIS were found to significantly differ between male subgroups according to stroke subtype (p = 0.050 and p < 0.001, respectively), as well as between children with anterior stroke and those with posterior stroke (p = 0.059 and p < 0.001, respectively). Post-stroke seizures appeared significantly more commonly in girls with TACI and POCI stroke than in girls with LACI and PACI stroke (p = 0.022). In turn, the prevalence of post-stroke hemiparesis differed between stroke subtypes in boys (p = 0.026). In conclusion, sex may have an impact in predisposing to a certain type of AIS in the patient. Post-stroke seizure may be related to stroke subtype in girls and hemiparesis in boys. However, further studies are needed to confirm the results.

Ultrasonographic elastography is a relatively new imaging modality for the qualitative and quantitative assessments of tissue elasticity. While it has steadily gained use in adult clinical practice, including for liver diseases, breast cancer, thyroid pathologies, and muscle and tendon diseases, data on its paediatric application is still limited. Moreover, diagnosis of muscular diseases in children remains challenging. The gold standard methods, namely biopsy, electroneurography, and electromyography, are often limited owing to their invasive characteristics, possible contraindications, complications, and need for good cooperation, that is, a patient’s ability to perform certain tasks during the examination while withstanding discomfort, which is a significant problem especially in younger or uncooperative children. Genetic testing, which has broad diagnostic possibilities, often entails a high cost, which limits its application. Thus, a non-invasive, objective, repeatable, and accessible tool is needed to aid in both the diagnosis and monitoring of muscle pathologies. We believe that elastography may prove to be such a method. The aim of this review was to present the current knowledge on the use of muscle elastography in the paediatric population and information on the limitations of elastography in relation to examination protocols and factors for consideration in everyday practice and future studies.

Background and objectives: In the paediatric population, hand injuries are one of the most frequent injuries and the second most frequent area of fracture. It is estimated that hand injuries account for up to 23% of the trauma-related causes of emergency department visits. Not only are they a significant factor in health care costs, but they may also lead to detrimental and long-term consequences for the patient. The discrepancy observed between the published studies suggests a geographical variation in their epidemiology. The aim of this study is to determine the localisation of injuries and fractures involving the hand in the paediatric population of the Polish Silesia region. This exploratory cross-sectional study involved 1441 post-traumatic hand X-ray examinations performed at the Department of Diagnostic Imaging of the John Paul II Upper Silesian Child Health Centre in Katowice between January and December 2014. Materials and Methods: The study group consisted of 656 girls and 785 boys who were 11.65 ± 3.50 and 11.51 ± 3.98 years old, respectively (range: 1–18 years). All examinations were evaluated for the location of the injury and presence of fracture(s). Results: Finger injuries were dominant (n = 1346), with the fifth finger being the most frequently injured (n = 381). The majority of injuries were observed among children who were 11 years old (n = 176), with a visible peak in the 11- to 13-year-old group. A total of 625 bone fractures were detected. Fractures of the proximal phalanges (n = 213) and middle phalanges (n = 159) were most common, and fifth finger (n = 189) predominance was again observed. A gender-independent positive correlation was found between patients’ age and finger injuries (p < 0.01) as well as metacarpal injuries (p < 0.01). There was no correlation between patients’ age and fractures in these locations (p > 0.05). Metacarpal injuries (p < 0.01), finger injuries (p < 0.01), fractures (p = 0.01), and fractures with displacement (p = 0.03) were more common among males regardless of age. Conclusions: The results indicate that 11-year-old boys are at an increased risk of hand injuries and fractures. The distal and middle phalanges of the right hand, especially of the fifth digit, were the most susceptible to fracture localisation. Thus, injuries in these areas should be perceived as most likely to cause fractures and therefore demand careful examination.

In developed countries, cerebrovascular diseases are among the 10 most common causes of death in both the pediatric and adult population. The prevalence of fatal outcomes following arterial ischemic stroke (AIS) in various groups of pediatric patients ranges from 1% to almost 32%. However, a constant improvement in stroke mortality among children has been observed. The extent of the decline differs among studies (from nearly tenfold to twofold decline), as it depends on the study population. While a portion of this variability might be explained by factors such as health care access, population age, diseases related to ethnicity, and different etiologies of stroke in studied populations, the understanding of such differences is still insufficient. Risk factors for death in the early stages of the disease are poorly understood and are usually based on the clinical presentations of relatively small groups of pediatric patients. Familiarity with these factors may be of significant importance for prognosis, but also for the early selection of patients requiring careful supervision. The present study aimed to analyze and discuss the current literature data on the incidence of early death and risk factors for early death in children suffering from stroke.

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Mózgowe porażenie dziecięce (MPD) jest jedną z najczęstszych przyczyn niepełnosprawności wśród dzieci, a terapia MPD jest jednym z głównych wyzwań neurologii dziecięcej. Pomimo dowodów na skuteczność rehabilitacji i interwencji chirurgicznych na poprawę funkcjonowania pacjentów z MPD, brak jest obecnie skutecznego leczenia, które zmniejszałoby nasilenie choroby i wpływało na trwałą poprawę funkcjonowania pacjentów. Jednym z priorytetowych tematów badawczych jest obecnie zastosowanie komórek macierzystych w terapii chorób neurologicznych, w tym w MPD. W ostatnich kilku latach wzrasta liczba dokonanych podań komórek macierzystych u pacjentów z MPD, jak również prowadzonych badań klinicznych. Niniejszy artykuł przedstawia aktualny stan wiedzy dotyczący terapii MPD komórkami macierzystymi w celu odpowiedzi na pytanie czy terapia komórkami macierzystymi to szansa na bardziej efektywne leczenie pacjentów z MPD. Słowa kluczowe: mózgowe porażenie dziecięce, choroby układu nerwowego, dziecko, komórki macierzyste, terapia komórkowa aBsTRaCT Cerebral palsy (CP) is one of the most common causes of disability among children and CP therapy is one of the main challenges in pediatric neurology. Despite evidence of the effectiveness of rehabilitation and surgical interventions to improve the functioning of patients with CP, there is no effective treatment that would reduce the severity of the disease and affect the permanent improvement of functioning. One of the leading topics of current research is the use of stem cells in the treatment of neurological diseases, including CP. In the last few years the number of stem cell applications in CP as well as clinical trials has been increasing. This article presents the current state of knowledge regarding stem cell therapy in order to answer the question whether stem cell therapy is an opportunity for more effective treatment of patients with CP.

Ogniskowa dysplazja korowa (FCD), będąca wynikiem zaburzonej migracji neuronalnej, pozostaje najczęstszą przyczyną neurochirurgicznego leczenia pacjentów z padaczką lekooporną, stanowiąc zarazem istotny problem zarówno w populacji dorosłej, jak i pediatrycznej. Pomimo obszerności poświęconej jej literatury naukowej, choroba ta, manifestująca się najczęściej pod postacią padaczki, pozostaje wyzwaniem zarówno w procesie diagnostyki, jak i w zakresie możliwości jej leczenia. Jej patogeneza pozostaje niejasna, a aktualnie stosowana klasyfikacja budzi pewne wątpliwości, zwłaszcza wobec braku odzwierciedlenia podziału w manifestacji klinicznej, rokowaniu i wynikach badań diagnostycznych poszczególnych typów. Ze względu na ograniczenia dostępnych i rutynowo stosowanych metod diagnostycznych, występowanie FCD, również w populacji bezobjawowej, wydaje się niedoszacowane. Nie ulega jednak wątpliwości, że jej udział w grupie pacjentów z padaczką lekooporną hospitalizowanych w oddziałach neurologii dziecięcej jest znaczny i dalsze próby zrozumienia tej jednostki chorobowej, a także opracowania skutecznych możliwości jej terapii są konieczne. Niniejszy artykuł jest próbą skróconego przedstawienia aktualnej wiedzy dotyczącej tej jednostki -jej obrazu klinicznego, podziału, patogenezy, diagnostyki, leczenia oraz rokowania.