2023波兰建议：儿童脑卒中的诊断与治疗

GUIDELINESNeurologia I Neurochirurga PolskaP202 3003Copyright2023 Polish Neurological Society1SSN:0028-3843,esSt1897-4260Polish recommendations for diagnosis and therapyof paediatric strokeEwa Pilarska",Ilona Kopyta",Edyta Szurowska,Julia Radon-Proskura',Ninela Irga-Jaworska',Grzegorz Kozera',Robert Sabiniewicz,Ewa Emich-Widera',Joanna Wojczal?'De partment of Developmental Neurology,Department of Neurology,Medical University of Gdansk,Gdansk,PolandDepartment of Paediatric Neurology,Faculty of Medical Sciences in Katowice,Medical University of Silesia,Katowice,PolandDepartment of Radiology,Faculty of Health Sciences,Medical University of Gdansk,Gdansk,Poland'Department of Paediatric Hematology and Oncology,Medical University of Gdansk,Gdansk,PolandMedicalSimulation Centre,Faculty of Medicine,Medical University of Gdansk,Poland and Department of Neurology,CopernicusHospital,Gdansk,PolandDepartment of Paediatric Cardiology and Congenital Heart Disease,Medical University of Gdansk,Gdansk,PolandDepartment of Neurology,Medical University of Lublin,Lublin,Poland"Both authors contributed equally to this work and considered to be co-first authorsABSTRACTStroke remains one of the greatest health challenges worldwide,due to a high mortality rate and,despite great progressin its treatment,the significant disability that it causes.Studies conducted around the world show that the diagnosis of stroke inchildren is often significantly delayed.Paediatric ischaemic arterial stroke(PAIS)is not onlya problem that varies greatly in frequency compared to the adult popula-tion,it is also completely different in terms of its risk factors,clinical course and outcome.The main reason for the lack of a rapid diagnosis of PAIS is a lack of access to neuroimaging under general anaesthesia.Theinsufficient knowledge regarding PAIS in society as a whole is also of great importance.Parents and carers of children shouldalways bear in mind that paediatric age is not a factor that excludes a diagnosis of stroke.The aim of this article was to develop recommendations for the management of children with acute neurological symptomssuspected ofischaemic stroke and further treatment after confirmation of the ischaemic aetiology of the problem.These recom-mendations are based on current global recommendations for the management of children with stroke,but our goal was alsoto match them as closelyas possible to the needs and technical diagnostic andtherapeutic possibilities encounteredin Poland.Due to the multifactorial problem of stroke in children,not only paediatric neurologists but also a neurologist,a paediatriccardiologist,a paediatric haematologist and a radiologist took part in the preparation ofthese recommendations.Key words:stroke,paediatric,risk factors,diagnosis,treatmentIntroduction17 million people suffer astroke each year,and about 90,000 ofthese are registered in Poland.Stroke remains the third most common cause of deathPaediatric arterial ischaemic stroke(PAIS)is not onlyw