ORIGINAL ARTICLES   

Minerva Pediatrica 2009 October;61(5):461-7

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Neurologic emergency in children’s hospital. Stroke

Palmieri A. ¹, Molinari A. C., Rossi A. ³, Gandolfo C. ², Lucigrai G. ⁴, Pavanello M. ⁵, Politanò T. ⁵, Vari M. S. ⁵, Di Pietro P. ⁶

¹ Unità Operativa di Medicina d’Urgenza, Centro Regionale di Trombosi ed Emostasi, Istituto Giannina Gaslini IRCCS, Genova, Italia 2 Unità Operativa di Radiologia, Centro Regionale di Trombosi ed Emostasi, Istituto Giannina Gaslini IRCCS, Genova, Italia 3 Unità Operativa di Neuroradiologia, Centro Regionale di Trombosi ed Emostasi, Istituto Giannina Gaslini IRCCS, Genova, Italia 4 Unità Operativa di Neurochirurgia, Centro Regionale di Trombosi ed Emostasi Istituto Giannina Gaslini IRCCS, Genova, Italia 5 Unità Operativa di Neuropsichiatria Infantile Centro Regionale di Trombosi ed Emostasi, Istituto Giannina Gaslini IRCCS, Genova, Italia 6 Dipartimento di Emato-Oncologia, Centro Regionale di Trombosi ed Emostasi, Istituto Giannina Gaslini IRCCS, Genova, Italia

Aim. The results may be related to the relative delay in diagnosis and thus in treatment. The authors hope that thier paper will help make physicians who work in emergency rooms more aware of the increase in stroke in children.
Methods and results. The study a departmental study in the Children’s Hospital, carried out at the Giannina Gasslini Children’s Hospital of Genoa, Italy. The authors report on 23 children with stroke who were admitted at onset to the pediatric emergency department. The incidence of patients with stroke at the Institute between 2001 and 2005, was 0.8% among neurology patients and 0.02% among all pediatric patients. This incidence would appear to be lower than the rates reported in the literature. This is most likely due to the fact that patients who presented at the Emergency Department at onset of the stroke were not taken in consideration. In the last few years, children with stroke have been treated empirically by anticoagulant or antiplatelet therapy. Patients with sickle cell disease, with venous stroke, or with heart disease are all treated in a rather homogeneous manner.
Conclusion. These cases represent the different types of presentation of stroke in children and also clearly display the different therapeutic strategies that have been applied. In fact, the patients were treated on the basis of an individual protocol which was decided case by case but a critical review of these cases establishes a necessary multidisciplinary protocol.