Intracerebral haemorrhage after the neonatal period.

Livingston, J. H.; Brown, Jane Κ.

doi:10.1136/adc.61.6.538

Cited by 27 publications

(23 citation statements)

References 23 publications

(2 reference statements)

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“…Most HS in children are supratentorial, and the basal ganglia are rarely involved. Three large series of children with HS revealed that over 80% of the hemorrhages were in the cortical region and less than 10% involved the basal ganglia [5,66,67].…”

Section: Epidemiologymentioning

confidence: 99%

Cerebrovascular disorders in children

Lynch

2004

Curr Neurol Neurosci Rep

100

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Cerebrovascular disorders are an important cause of mortality and chronic morbidity in children. International incidence rates for childhood stroke (ie, from 30 days to 18 years of age) have ranged from 1.3 to 13 per 100,000 children. Ischemic stroke is probably more common than hemorrhagic stroke in children. The clinical presentation of stroke in children varies according to age and location of the stroke. Over 100 risk factors for stroke in children have been reported, but in up to one third of cases no cause is identified. The management and prevention of stroke in children is not well studied and current recommendations are based on adult studies, nonrandomized trials, or expert opinion. Over half of children with stroke will develop lifelong cognitive or motor disability and up to one third will have a recurrent stroke. This review briefly describes the epidemiology, risk factors, evaluation, treatment, and outcome of stroke in children.

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Section: Epidemiologymentioning

confidence: 99%

Cerebrovascular disorders in children

Lynch

2004

Curr Neurol Neurosci Rep

100

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“…No child in this study cohort had ICH related to hypertension although other studies have reported hypertension as a risk factor in <5% of children with ICH. 21,22 …”

Section: Commentmentioning

confidence: 99%

Frequency of Hematoma Expansion After Spontaneous Intracerebral Hemorrhage in Children

et al. 2014

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IMPORTANCE Hematoma expansion is the only modifiable predictor of outcome in adult intracerebral hemorrhage; however, the frequency and clinical significance of hematoma expansion after childhood intracerebral hemorrhage are unknown.OBJECTIVE To assess the frequency and extent of hematoma expansion in children with nontraumatic intracerebral hemorrhage. DESIGN, SETTING, AND PARTICIPANTSProspective observational cohort study at 3 tertiary care pediatric hospitals. Children (Ն37 weeks' gestation to 18 years) with nontraumatic intracerebral hemorrhage were enrolled in a study from 2007 to 2012 focused on predictors of outcome. For this planned substudy of hematoma expansion, neonates 28 days or younger and participants with isolated intraventricular hemorrhage were excluded. Children with 2 head computed tomography (CT) scans within 48 hours were evaluated for hematoma expansion and were compared with children with only 1 head CT scan. Consent for the primary cohort was obtained from 73 of 87 eligible participants (84%); 41 of 73 children enrolled in the primary cohort met all inclusion/exclusion criteria for this substudy, in whom 22 had 2 head CT scans obtained within 48 hours that could be evaluated for hematoma expansion. Within our substudy cohort, 21 of 41 (51%) were male, 25 of 41 (61%) were white, 16 of 41 (39%) were black, and median age was 7.7 years (interquartile range, 2.0-13.4 years). MAIN OUTCOME AND MEASURE Primary outcome was prevalence of hematoma expansion.RESULTS Of 73 children, 41 (56%) met inclusion criteria, and 22 (30%) had 2 head CT scans to evaluate expansion. Among these 22 children, median time from symptom onset to first CT was 2 hours (interquartile range, 1.3-6.5 hours). Median baseline hemorrhage volume was 19.5 mL, 1.6% of brain volume. Hematoma expansion occurred in 7 of 22 (32%). Median expansion was 4 mL (interquartile range, 1-11 mL). Three children had significant (>33%) expansion; 2 required urgent hematoma evacuation. Expansion was not associated with poorer outcome. Compared with children with only 1 head CT scan within 48 hours, children with 2 head CT scans had larger baseline hemorrhage volumes (P = .05) and were more likely to receive treatment for elevated intracranial pressure (P < .001). CONCLUSIONS AND RELEVANCEHematoma expansion occurs in children with intracerebral hemorrhage and may require urgent treatment. Repeat CT should be considered in children with either large hemorrhage or increased intracranial pressure.

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“…Improvements in pediatric critical care and neurosurgical techniques may account from some of this reduction in mortality [7,72]. Pooled data from multiple, somewhat heterogeneous studies suggest an average mortality of 25% in children with HS [6], although individual study estimates range from 7% [73] to 54% [22].…”

Section: Neurologic Outcome and Hs Recurrencementioning

confidence: 99%

“…Hematologic abnormalities are reported to be the major risk factor in 10 to 30% of HS in most series [5,12,15,22]. Hematologic causes of IPH include thrombocytopenia and hemophilia, and coagulopathies.…”

Section: Risk Factors For Hs In Childhoodmentioning

confidence: 99%

Hemorrhagic Stroke in Children

Jordan

Hillis

2007

Pediatric Neurology

112

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Hemorrhagic stroke accounts for approximately half of stroke in childhood. Unlike arterial ischemic stroke, there are no consensus guidelines to assist in the evaluation and treatment of these children. We review the literature on the evaluation, treatment, etiology and neurologic outcome of hemorrhagic stroke in children. Important differences between pediatric and adult hemorrhage are highlighted, as treatment guidelines for adults may not be applicable in all cases. Needed future research and potential therapies are also discussed.

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Intracerebral haemorrhage after the neonatal period.

Cited by 27 publications

References 23 publications

Cerebrovascular disorders in children

Cerebrovascular disorders in children

Frequency of Hematoma Expansion After Spontaneous Intracerebral Hemorrhage in Children

Hemorrhagic Stroke in Children

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