Ictus: un reto diagnóstico <span class="so-article-trans-title" dir="auto"> Translated title: Stroke: a diagnostic challenge </span>

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Abstract

Resumen El ictus se define como un déficit neurológico focal que dura más de 24 horas y tiene una base vascular. Su incidencia en la infancia es baja, pero puede causar una morbilidad y mortalidad importantes. La baja incidencia, las múltiples manifestaciones clínicas con las que se puede presentar y la escasa conciencia que se tiene de él son las causas que inducen a un retraso del diagnóstico.

Translated abstract

Abstract Stroke is defined as a focal neurological deficit that lasts more than 24 hours and has a vascular base. Its incidence in the childhood is low, but it can cause an important morbidity and mortality. The low incidence, the multiple clinical manifestations with which it can be presented and the low awareness of it are the causes that induce a delay in diagnosis.

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Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Donna Ferriero, Heather Fullerton, Timothy J Bernard … (2019)

Purpose- Much has transpired since the last scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods- Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee and were chosen to reflect the expertise of the subject matter. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. This scientific statement is based on expert consensus considerations for clinical practice. Results- Annualized pediatric stroke incidence rates, including both neonatal and later childhood stroke and both ischemic and hemorrhagic stroke, range from 3 to 25 per 100 000 children in developed countries. Newborns have the highest risk ratio: 1 in 4000 live births. Stroke is a clinical syndrome. Delays in diagnosis are common in both perinatal and childhood stroke but for different reasons. To develop new strategies for prevention and treatment, disease processes and risk factors that lead to pediatric stroke are discussed here to aid the clinician in rapid diagnosis and treatment. The many important differences that affect the pathophysiology and treatment of childhood stroke are discussed in each section. Conclusions- Here we provide updates on perinatal and childhood stroke with a focus on the subtypes, including arterial ischemic, venous thrombotic, and hemorrhagic stroke, and updates in regard to areas of childhood stroke that have not received close attention such as sickle cell disease. Each section is highlighted with considerations for clinical practice, attendant controversies, and knowledge gaps. This statement provides the practicing provider with much-needed updated information in this field.