Uma doença isquêmica rara, caracterizada pela falta de sangue e morte de células em uma área específica do cérebro. Isso acontece devido ao bloqueio de uma artéria cerebral, o que prejudica o fornecimento de sangue e oxigênio para as células do cérebro.
Introdução
O que você precisa saber de cara
Uma doença isquêmica rara, caracterizada pela falta de sangue e morte de células em uma área específica do cérebro. Isso acontece devido ao bloqueio de uma artéria cerebral, o que prejudica o fornecimento de sangue e oxigênio para as células do cérebro.
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Entender a doença
Do básico ao detalhe, leia no seu ritmo
Preparando trilha educativa...
Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 1 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — AVC arterial isquêmico pediátrico
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Publicações mais relevantes
Circadian Variability in Pediatric Arterial Ischemic Stroke.
To assess whether the timing of ischemic stroke onset demonstrates circadian variability in children. We performed a retrospective cohort study evaluating children with arterial ischemic stroke and known time of stroke onset who were enrolled in a large, multicenter pediatric stroke registry. Clinical and radiographic features were compared according to 4 time epochs-6:00-11:59 (morning), 12:00-17:59 (afternoon), 18:00-23:59 (evening), and 00:00-5:59 (night)-using Kruskal-Wallis and chi-square tests. Pairwise comparisons were conducted when needed. A total of 478 patients were included, with 54% male and a mean age of 9.9 ± SD 5.7 years. We observed a rise in stroke frequency in the morning that plateaued around 10:00, with a sustained high frequency into the early afternoon; most strokes occurred in the afternoon (n = 185, 38.7%), followed by the morning (n = 156, 32.6%). Arteriopathy risk factors were more prevalent in nighttime strokes (23/36, P = .034). Patients in the <2, 2-5, and 6-11-year-old age groups had a higher proportion of strokes in the afternoon (42%, 38%, and 45%, respectively). There was a trend for better median 6-month pediatric stroke outcome measure scores after evening strokes (0.5, IQR 0-1.5) compared with morning strokes (1, IQR 0.5-2) and afternoon strokes (1, IQR 0.5-3), P = .033, but this was not statistically significant after adjustment for multiple comparisons. Circadian influence on stroke timing appears to differ between adults and children. These findings could influence stroke systems of care and treatment strategies for pediatric stroke.
Post-Varicella Arteriopathy as a Cause of Pediatric Arterial Ischemic Stroke: A Systematic Review and Case Report.
Post-varicella arteriopathy (PVA) is a significant cause of pediatric arterial ischemic stroke (AIS) that typically involves previously healthy children within 12 months of primary varicella infection, mostly with a monophasic course. Diagnosis is based on clinical and imaging findings, and cerebrospinal fluid analysis may confirm it; treatment is empirical and heterogeneous. We describe a typical case of PVA and present a systematic review of its clinical, radiological, therapeutic, and outcome features. Following PRISMA 2020 and AMSTAR-2 guidelines, data on demographics, clinical presentation, imaging, laboratory confirmation, treatment, and outcomes were extracted across databases (PubMed, Embase, Scopus). Forty-seven studies, encompassing 312 pediatric patients, were included. Mean age was 4 years with a median latency of 3.82 months from varicella to neurologic symptoms. Common presentation included hemiparesis, language impairment, and seizures. Imaging findings showed unilateral focal involvement of anterior circulation arteries, basal ganglia infarctions, and, rarely, bilateral or posterior circulation involvement. CSF VZV-DNA PCR and anti-VZV IgG were positive in 39% and 48% of tested patients. Treatment included intravenous acyclovir (34%), corticosteroids (20%), and low-dose aspirin (77%); two patients underwent acute reperfusion therapy (rt-PA or thrombectomy). Outcomes tended to be moderately favorable: 43% achieved full recovery, 45% had residual deficit, and 11% experienced recurrence. Prothrombotic state was reported, and it may influence disease severity. PVA is a rare distinct cause of pediatric stroke, with a generally favorable prognosis quoad vitam. Standardized guidelines and prospective studies are needed to establish evidence-based management. Clinicians should maintain a high suspicion for its diagnosis.
Comparison of Risk Factors and Outcomes in Pediatric Posterior and Anterior Circulation Arterial Ischemic Stroke: A Cross-Sectional Analysis.
Pediatric arterial ischemic stroke (AIS) is a rare but serious condition leading to significant neurological disability. AIS is classified into anterior circulation AIS (ACAIS) and posterior circulation AIS (PCAIS). Understanding the differences between these subtypes is essential for early diagnosis and effective management. This study aimed to evaluate the demographic, clinical, and laboratory characteristics of pediatric ACAIS and PCAIS, focusing on lipid profiles, prothrombotic factors, and SARS-CoV-2 prevalence. A descriptive-analytical cross-sectional study was conducted on 34 children diagnosed with AIS at the Tabriz Children's Hospital from March 2020 to October 2021. Patients were categorized into ACAIS, PCAIS, and mixed, involving both anterior and posterior circulations based on neuroimaging findings. Demographic data, medical history, and laboratory parameters, including coagulation factors, lipid profiles, and SARS-CoV-2 antibodies, were analyzed. Statistical comparisons were performed using SPSS version 26, with a p-value of <0.05 considered statistically significant. Among the 34 patients, 73.5% were diagnosed with ACAIS, 20.6% with PCAIS, and 5.9% with both. PCAIS patients were older (median age: 8.0 vs. 2.0 years), and sex distribution varied, although not significantly. No significant differences were found in lipid profiles, coagulation factors, or SARS-CoV-2 prevalence between ACAIS and PCAIS groups. No significant differences in demographic features, lipid profiles, or prothrombotic conditions were observed between ACAIS and PCAIS, suggesting that pediatric stroke mechanisms may differ from those in adults. Further large-scale studies are warranted to validate these findings and improve pediatric stroke management.
Successful Mechanical Thrombectomy and Balloon Angioplasty in Two Children With Arterial Ischemic Stroke Caused by Focal Cerebral Arteriopathy.
Mechanical thrombectomy (MT), although well established in adults, is gaining acceptance as a viable treatment in pediatric patients, especially with cardioembolic etiology. However, there is an ongoing debate about the use of MT in children with arterial ischemic stroke due to suspected focal cerebral arteriopathy (FCA). Here, we present two cases of pediatric arterial ischemic stroke with high suspicion of FCA successfully treated with MT, highlighting its potential utility in this population. In addition, both cases were treated with balloon angioplasty successfully; thus this report aims to open a discussion on this potential rescue treatment in children with FCA. Clinical and imaging diagnosis, technical details of the procedure, and clinical course of the patients with suspected FCA are presented. Both children presented with M1 occlusions with clinical and imaging features suggesting underlying FCA. After initial thrombectomy, one child had an immediate reocclusion and one presented with residual high-grade stenosis. In both cases, balloon angioplasty of the M1 segment was performed and follow-up imaging confirmed regressive stenosis. Both children had favorable neurological outcomes with a modified Rankin Scale score of 1 at 90 days and one year, respectively. We describe the successful endovascular treatment of two children with occlusion of the middle cerebral artery due to suspected FCA. In carefully selected and severely affected patients, balloon angioplasty may be an option to secure blood flow distal of the occlusion.
Identification of Monogenic Causes of Arterial Ischemic Stroke in Children with Arteriopathies by Next-Generation Sequencing.
The leading causes of pediatric arterial ischemic stroke (PAIS) are arteriopathies, which refer to pathologies of the arterial walls in the brain. Since traditional risk factors for cardiovascular diseases in children play a smaller role than in adults, it can be supposed that genetic factors may be of particular importance in this age group. Therefore, this study aimed to identify mutations affecting the formation of vascular wall pathologies, which can subsequently lead to ischemic stroke. The study used a database of 92 Caucasian children diagnosed with ischemic stroke. From this group, 25 children with arteriopathies were selected. The study had an exploratory and descriptive design, with the aim of characterizing rare genetic variants in a selected cohort, without attempting formal statistical association testing. The sequencing was performed using the Illumina NextSeq 550 platform. A panel of 161 genes known to be associated with stroke or arteriopathies was selected for further analysis. We identified 10 pathogenic or likely pathogenic mutations in 15 patients. Among these, three are likely monogenic causes of stroke (ELN, SCN5A, and VHL genes), two are considered risk factors (FV and ADAMTS13), two have conflicting interpretations (ACAD9 and ENG), and three are most likely benign (CBS, PMM2, and PKD1). The frequency of genetic variants underlying ischemic stroke or acting as risk factors for the disease in the studied group is significantly higher than the estimated frequency of monogenic forms of stroke in young adults and higher than in the general population. NGS testing is worth considering, especially in patients who exhibit certain symptoms that may suggest the presence of mutations.
Publicações recentes
Uncovering the missing links: autoimmunity and infection in pediatric arterial ischemic stroke.
🥉 Relato de casoCircadian Variability in Pediatric Arterial Ischemic Stroke.
Post-Varicella Arteriopathy as a Cause of Pediatric Arterial Ischemic Stroke: A Systematic Review and Case Report.
Comparison of Risk Factors and Outcomes in Pediatric Posterior and Anterior Circulation Arterial Ischemic Stroke: A Cross-Sectional Analysis.
📚 EuropePMC54 artigos no totalmostrando 90
Circadian Variability in Pediatric Arterial Ischemic Stroke.
The Journal of pediatricsPost-Varicella Arteriopathy as a Cause of Pediatric Arterial Ischemic Stroke: A Systematic Review and Case Report.
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Iranian journal of child neurologyTreatment of a Pediatric Arterial Ischemic Stroke With Tenecteplase.
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Expert review of neurotherapeuticsSuccessful Mechanical Thrombectomy and Balloon Angioplasty in Two Children With Arterial Ischemic Stroke Caused by Focal Cerebral Arteriopathy.
Pediatric neurologyIdentification of Monogenic Causes of Arterial Ischemic Stroke in Children with Arteriopathies by Next-Generation Sequencing.
International journal of molecular sciencesThrombectomy Versus Medical Management for Pediatric Arterial Ischemic Stroke With Large Baseline Infarct.
StrokebFGF Knockdown Inhibits mTOR Signaling by Suppressing Caveolin-1 and Aggravates Cognitive Damage After Arterial Ischemic Brain Injury in Juvenile Rats.
Molecular neurobiologySpatio-Temporal Signatures of Cognitive Function After Pediatric Arterial Ischemic Stroke-A Pilot Study.
Human brain mappingImproving Timely Diagnosis of Arterial Ischemic Stroke at a Pediatric Emergency Department.
PediatricsDoes Time and Experience Matter in Pediatric Arterial Ischemic Stroke (AIS) Intervention in Patients with an Initial Clinical Presentation of Mild/Moderate Severity? Long-Term Follow-Up Experience of a Single Tertiary Clinic.
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Human brain mappingFLAIR Vascular Hyperintensities as Imaging Biomarker in Pediatric Acute Ischemic Stroke.
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Acta neurologica BelgicaTenecteplase for the Treatment of Pediatric Arterial Ischemic Stroke: A Safety Surveillance Report.
NeurologyLong-Term Neurologic Outcomes in Pediatric Arterial Ischemic Stroke: The Impact of Age and Lesion Location.
StrokeDeterminants of Timely Access to Recanalization Treatments and Outcomes in Pediatric Ischemic Stroke.
StrokeThe association between lipoprotein(a) levels and ischemic stroke in children: A case-control study.
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Seminars in pediatric neurologyThe Role of Infection and Inflammation in the Pathogenesis of Pediatric Arterial Ischemic Stroke.
Seminars in pediatric neurology[Expert consensus on diagnosis and treatment of pediatric arterial ischemic stroke].
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Pediatric neurologyAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Circadian Variability in Pediatric Arterial Ischemic Stroke.
- Post-Varicella Arteriopathy as a Cause of Pediatric Arterial Ischemic Stroke: A Systematic Review and Case Report.
- Comparison of Risk Factors and Outcomes in Pediatric Posterior and Anterior Circulation Arterial Ischemic Stroke: A Cross-Sectional Analysis.
- Successful Mechanical Thrombectomy and Balloon Angioplasty in Two Children With Arterial Ischemic Stroke Caused by Focal Cerebral Arteriopathy.
- Identification of Monogenic Causes of Arterial Ischemic Stroke in Children with Arteriopathies by Next-Generation Sequencing.
- Reply to the Letter: "Uncovering the Missing Links: Autoimmunity and Infection in Pediatric Arterial Ischemic Stroke".
- Uncovering the missing links: autoimmunity and infection in pediatric arterial ischemic stroke.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:439175(Orphanet)
- MONDO:0018585(MONDO)
- GARD:21824(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q55788195(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
