Pediatric arterial ischemic stroke in Japan: Moyamoya disease or not
Pediatric arterial ischemic stroke in Japan: Moyamoya disease or not
复制标题
日本小儿动脉缺血性中风：烟雾病与否
DOI：
10.1016/j.jstrokecerebrovasdis.2023.107063
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Mori N.
中科院分区：
文献类型：
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作者：
Mugikura S;Mori N.
尊敬的编辑：我们怀着极大的兴趣阅读了Scoville J等人的文章，该文章调查了属于儿童医院协会的儿童医院，以确定关于儿科动脉缺血性卒中（AIS）诊断和治疗方案的共识。1在这项研究中，在50家儿科医院的93名医生的响应者中，对于使用静脉组织纤溶酶原激活剂（tPA）治疗儿科AIS的共识率为90.3%，对于机械血栓切除术的共识率为77.4%。这一结果激起了我们对日本儿童AIS管理现状的兴趣，并从流行病学的角度讨论了烟雾病是日本儿童AIS的主要原因。最近对2010年至2014年期间居住在日本爱知县的40名经放射学证实的AIS儿童进行的调查表明，住院延迟与儿科AIS的诊断有关，可能是由于医生缺乏对AIS的认识。2对26例AIS患儿进行诊断时间分析，其中烟雾病8例，心脏病5例，原因不明8例。在本研究中，从症状发作到确诊AIS诊断的中位时间为27.0小时，任何患者均未进行静脉tPA和机械血栓切除术。我们完全同意他们的结论，即需要进一步努力提高公众和医生对儿科AIS的认识，以确保儿科AIS的早期识别，诊断和治疗。
Dear Editor: We read with great interest the article by Scoville J et al. that surveyed children's hospitals belonging to the Children’s Hospital Association to determine the consensus regarding the diagnostic and treatment protocols for pediatric arterial ischemic stroke (AIS). 1 In this study, among 93 responders from physicians in 50 pediatric hospitals, consensus agreement, being available to treat pediatric AIS, was 90.3% in the use of intravenous tissue plasminogen activator (tPA) and 77.4% in mechanical thrombectomy. This result piqued our interest in the current state of management for pediatric AIS in Japan and in discussing the state from the epidemiological perspective that moyamoya disease is the leading cause of pediatric AIS in Japan.A recent survey of 40 children residing in the Aichi Prefecture of Japan with radiologically confirmed AIS between 2010 and 2014 suggested that the long in-hospital delays are associated with the diagnosis of pediatric AIS, likely due to a lack of awareness of AIS by physicians. 2 The 26 children with AIS, in whom time to diagnosis was analyzed, included eight children with moyamoya disease, five with cardiac disease, eight with unknown causes. In this study, the median time from symptom onset to confirmed AIS diagnosis was 27.0 h and intravenous tPA and mechanical thrombectomy were not performed in any patient. We completely agree with their conclusion that further efforts to increase public and physician awareness of pediatric AIS are needed to ensure the early recognition, diagnosis, and treatment of pediatric AIS.