Arterial Ischemic Stroke in Children and Young Adults.
Arterial Ischemic Stroke in Children and Young Adults.
复制标题
DOI：
10.1212/con.0000000000000438
复制
发表时间：
2017-02-01
期刊：
影响因子：
--
通讯作者：
Kumar, Riten
中科院分区：
文献类型：
--
作者：
Lo, Warren D;Kumar, Riten
综述目的：本文综述了儿童和年轻人动脉缺血性卒中的危险因素、复发风险、评估、管理和结局。最新发现：新生儿和儿童中风的复发和死亡风险似乎很低。大多数儿童有相对轻微的缺陷，但那些有更大的神经缺陷、中风后癫痫或生命早期中风的儿童有整体认知功能下降的风险。年轻人中风后的复发率和长期死亡率比原先认为的要高。认知障碍、抑郁和焦虑与卒中后较高的失业率相关，是卒中后改善护理的目标。年轻人中风后的护理不仅仅涉及医疗管理。自我报告的记忆和执行功能障碍可能比客观测量检测到的更严重。评估可能的认知障碍和适当的心理合并症管理是最大限度地提高中风幸存者长期功能结局的关键。摘要：儿童和青年中风幸存者比老年中风患者存活的时间更长。为了确保这些幸存者最大限度地提高他们的生活效率，神经学家不仅要优化医疗管理，还要认识到认知和情绪障碍可能是长期功能独立的可补救障碍。
PURPOSE OF REVIEW: This article reviews risk factors, recurrence risk, evaluation, management, and outcomes of arterial ischemic stroke in children and young adults.RECENT FINDINGS: The risk for recurrence and mortality appear to be low for neonatal and childhood stroke. Most children have relatively mild deficits, but those who have greater neurologic deficits, poststroke epilepsy, or strokes early in life are at risk for lower overall cognitive function. Stroke recurrence and long-term mortality after stroke in young adults are greater than originally thought. Cognitive impairments, depression, and anxiety are associated with higher levels of poststroke unemployment and represent targets for improved poststroke care. Poststroke care in young adults involves more than medical management. Self-reported memory and executive function impairments may be more severe than what is detected by objective measures. Assessment of possible cognitive impairments and appropriate management of psychological comorbidities are key to maximizing the long-term functional outcome of stroke survivors.SUMMARY: Childhood and young adult stroke survivors survive for many more years than older patients with stroke. To ensure that these survivors maximize the productivity of their lives, neurologists must not only optimize medical management but also recognize that impairments in cognition and mood may be remediable barriers to long-term functional independence.