Pediatric Stroke Among Hong Kong Chinese Subjects

Chung, Brian Hon Yin; Wong, Virginia

doi:10.1542/peds.114.2.e206

Cited by 154 publications

(149 citation statements)

References 28 publications

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“…The treatment parameters at the initial GKS were as follows: mean prescription dose 21.9 Gy (range 7.5-35 Gy); mean maximum dose 40.1 Gy (range 20-50 Gy); mean isodose line 56% (range 30%-90%); and mean number of isocenters 2.9 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The treatment parameters of the second GKS were as follows: mean prescription dose 20.7 Gy (range 4-27.5 Gy); mean maximum dose 39.6 Gy (range 8-50 Gy); mean isodose line 53% (range 50%-71%); and mean number of isocenters 4 (range .…”

Section: Treatment Parametersmentioning

confidence: 99%

Gamma Knife surgery for arteriovenous malformations in children

Yen¹,

Monteith²,

Nguyen³

et al. 2010

PED

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Object The aim of this study was to evaluate the long-term imaging and clinical outcomes of intracranial arteriovenous malformations (AVMs) in children treated with Gamma Knife surgery (GKS). Methods Between 1989 and 2007, 200 patients with AVMs who were 18 years of age or younger were treated at the University of Virginia Health System. Excluding 14 patients who had not reached 2-year follow-up, 186 patients comprised this study. Hemorrhage was the most common presenting symptom leading to the diagnosis of AVMs (71.5%). The mean nidus volume was 3.2 cm3 at the time of GKS, and a mean prescription dose of 21.9 Gy was used. Results After initial GKS, 49.5% of patients achieved total angiographic obliteration. Forty-one patients whose AVM nidi remained patent underwent additional GKS. The obliteration rate increased to 58.6% after a second or multiple GKS. Subtotal obliteration was achieved in 9 patients (4.8%). Forty-nine patients (26.3%) still had a patent residual nidus. In 19 patients (10.2%), obliteration was confirmed on MR imaging only. Ten patients had 17 hemorrhages during the follow-up period. The hemorrhage rate was 5.4% within 2 years after GKS and 0.8% between 2 and 5 years. Six patients developed neurological deficits along with the radiation-induced changes. Two patients developed asymptomatic meningiomas 10 and 12 years after GKS. After a mean clinical follow-up of 98 months, less than 4% of patients had difficulty attending school or developing a career. Conclusions Gamma Knife surgery offers a reasonable chance of obliteration of an AVM in pediatric patients. The incidence of symptomatic radiation-induced changes is relatively low; however, long-term clinical and imaging follow-up is required to identify delayed cyst formation and secondary tumors.

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Section: Treatment Parametersmentioning

confidence: 99%

Gamma Knife surgery for arteriovenous malformations in children

Yen¹,

Monteith²,

Nguyen³

et al. 2010

PED

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“…Arteriovenous malformations (AVM) account for 14% [19] to 46% [12] of HS in children and nearly 50% of IPH [16]. Cavernous malformations are infrequently mentioned as an etiology for HS in childhood, probably because they are generally detected on MRI.…”

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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“…Pequenos estudos realizados demonstraram que lesões complicadas por efeito de massa beneficiaram de intervenção cirúrgica precoce. 23 Foi realizada intervenção neurorradiológica com embolização de MAV em quatro doentes. Este tipo de intervenção visa reduzir a dimensão da lesão ou obliterá-la na totalidade.…”

Section: Discussionunclassified

Acidentes Vasculares Cerebrais em Idade Pediátrica: O Papel dos Cuidados Intensivos

Ferreira

Rebelo

Aguilar

et al. 2017

Acta Pediátrica Port

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Acta Pediatr Port 2017;48:245-52Resumo Introdução: As lesões vasculares do sistema nervoso central, nomeadamente o acidente vascular cerebral hemorrágico, o acidente vascular cerebral isquémico e trombose venosa cerebral, são causa importante de morbilidade e mortalidade. Existem poucos estudos sobre a melhor abordagem terapêutica em pediatria. O objetivo deste estudo foi descrever a abordagem e outcome neurológico dos doentes admitidos numa unidade de cuidados intensivos pediátricos com lesões vasculares cerebrais não traumáticas. Métodos: Estudo retrospetivo baseado nos processos clínicos de doentes internados numa unidade de cuidados intensivos pediátricos entre janeiro de 2007 e dezembro de 2013 com lesão vascular cerebral não traumática. Resultados: Incluíram-se 45 doentes, mediana da idade 8,2 anos, 70% do sexo masculino. Ocorreram 22 casos (49%) de acidente vascular cerebral hemorrágico, 15 de acidente vascular cerebral isquémico (33%) e oito de trombose venosa cerebral (18%). Necessitaram de intervenção neurocirúrgica 18 doentes e neurorradiológica cinco doentes. Um doente fez trombólise sistémica utilizando alteplase, 76% necessitaram de controlo médico da hipertensão intracraniana, 57% de ventilação mecâ-nica, 30% de suporte cardiovascular e 28% de terapêutica antiepilética. Ocorreram cinco óbitos (11%), quatro em doentes com acidente vascular cerebral hemorrágico. Utilizando a escala KOSCHI (King's Outcome Scale for Childhood Head Injury), atualmente 23 (51%) doentes são independentes, incluindo 17 que não apresentam qualquer sequela. Discussão: Registaram-se, em média, seis internamentos por ano por acidente vascular cerebral não traumático, sendo mais frequente o hemorrágico. A precocidade do diagnóstico e a referenciação atempada para centros especializados são cruciais para a melhoria do prognóstico. A abordagem multidisciplinar num centro com disponibilidade permanente de recursos humanos e materiais terá contribuído para a sobrevida e boa recuperação funcional verificada na maioria dos casos. Palavras-chave:Acidente Vascular Cerebral; Criança; Unidades de Cuidados Intensivos Pediátricos; Trombose Venosa Abstract Introduction: Vascular brain lesions, including haemorrhagic stroke, ischaemic stroke and cerebral venous thrombosis, are important causes of morbidity and mortality. Paediatric studies regarding the best therapeutic approach are scarce. The aim of this study was to describe the therapeutic approach and neurological outcome in patients admitted to a paediatric intensive care unit with non-traumatic vascular brain lesions. Methods: A retrospective analysis was conducted using medical records of patients with non-traumatic vascular brain lesions admitted to a paediatric intensive care unit between January 2007 and December 2013. Results: Forty-five patients were included, 70% male, median age 8.2 years. There were 22 cases (49%) of haemorrhagic stroke, 15 (33%) of ischaemic stroke and

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Pediatric Stroke Among Hong Kong Chinese Subjects

Cited by 154 publications

References 28 publications

Gamma Knife surgery for arteriovenous malformations in children

Gamma Knife surgery for arteriovenous malformations in children

Hemorrhagic Stroke in Children

Acidentes Vasculares Cerebrais em Idade Pediátrica: O Papel dos Cuidados Intensivos

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