- 期刊
Strokes in Children: A Medical Center-based Study
兒童期之腦血管疾病－醫學中心之研究報告
摘要
腦血管疾病雖僅占孩童疾病之一小部分，但仍爲孩童時期死亡率及罹病率之重要因素之一。此研究謹就台灣大學附設醫院自民國七十四年一月起至八十四年十二月止之兒童腦血管疾病患者作一分析報告。在此期間共有六十五名之兒童患者診斷爲腦血管疾病，包括三十七名男孩及二十八名女孩，其中排除了早産兒，頭部外傷。依不同的病理致病機轉區分爲以下二類：一、腦梗塞，二、腦出血。將此二類病人依發病年齡、臨床表現、致病原因及治療作一分析比較。腦梗塞、腦出血之主要臨床表現分別爲：運動功能失調及意識不清。研究中發現不同之腦血管疾病各有不同之誘發因素。腦出血之常見原因爲腦血管畸形，血液及腫瘤疾病，腦梗塞之常見原因爲亞屬血液病。其死亡率分別爲37%及21.1%。總之，臨床特徵只能作爲某些鑑別診斷之指標，神經影像學檢查仍爲重要的鑑別工具。早期診斷早期治療及預防疾病的惡化對病人之預後最爲重要。
並列摘要
Stroke is an important cause of mortality and morbidity in children. Cases of pediatric stroke admitted to National Taiwan University Hospital from January 1985 to December 1995 were reviewed. Patients whose stroke was obviously caused by premature birth, birth trauma or head injury, were excluded. Totally 65 patients were enrolled, including 37 boys and 28 girls. Their ages ranged from birth to 18 years old. They were classified into two groups: ischemic stroke (38 patients) and hemorrhagic stroke (27 patients), according to the pathogenesis. The ages of onset, clinical manifestation, underlying diseases and treatment of these two groups were systematically analyzed. The major presenting symptoms of both ischemic and hemorrhagic strokes were motor deficit (65.8%) and consciousness disturbance (55.6%). A wide variety of diseases predisposing to strokes was identified. The major causes of hemorrhagic stroke were vascular malformation and oncologic conditions, with the latter, the most frequently encountered underlying diseases associated with childhood ischemic stroke. The mortality rate for hemorrhagic stroke was 37% and, for ischemic stroke, 21.1%. There was male predominance in pediatric stroke. Although the clinical symptoms and signs might provide some guidelines to differentiate between hemorrhagic and ischemic strokes, neuroimaging studies were crucial to more exact diagnosis. A variety of diseases may contribute to pediatric stroke. Early diagnosis determine treatability, then aggressive treatment are important.