[Long-term prognosis of children with cerebrovascular disease].

OBJECTIVE:Reports of the prognosis of cerebrovascular disease (CVD) in children have not been common. We investigated the prognoses in 71 children with CVD, which were composed of 43 and 28 patients, suffering from hemorrhagic stroke (HS) and ischemic stroke (IS), respectively. They were followed for at least one year after the stroke event. METHODS:The average age of onset was 9 years 8 months in HS and 6 years 8 months in IS, the present ages being 13 years 5 months and 12 years 5 months, respectively. The medical records were reviewed, and the clinical courses during the acute stage and the state of sequelae were investigated. RESULTS:The etiologies were rupture of the arteriovenous malformation in 29 cases in HS, and traumatic brain damage, during rewarming from hypothermia therapy or during operations such as for heart diseases in IS. An age-related characteristic was seen in the heart diseases operation group. The main damaged regions were the frontal lobe, temporal lobe, parietal lobe, and cerebellum in HS, and the middle cerebral arterial area, basal ganglia, and frontal lobe in IS. The damage in the infra-tentorial area was more frequent in HS than in IS. The sequelae comprised physical disabilities in 39 cases with HS and 25 cases with IS, mental disabilities in 11/11, epilepsy in 4/7, and higher brain dysfunction such as attention deficit in 31/26. Severe disabilities were low as one case each. CONCLUSION:The etiology, region, and sequelae differed between HS and IS in children.