Avtor/Urednik     Perkovič-Benedik, Mirjana; Zaletel, Marjan; Pečarič-Meglič, Nuška; Podnar, Tomaž
Naslov     A right-to-left shunt in children with arterial ischaemic stroke
Tip     članek
Vir     Arch Dis Child
Vol. in št.     Letnik 96, št. 5
Leto izdaje     2011
Obseg     str. 461-7
Jezik     eng
Abstrakt     Objective: To compare the prevalence and grade of right-to-left shunt (RLS) in children with arterial ischaemic stroke (AIS) and in controls. Design: Prospective study. Sstting: Tertiary paediatric referral centre. Patients 30 consecutive children with AIS. Intervention: Contrast transcranial Doppler (cTCD) with Valsalva manoeuvre was performed in children with AIS and in controls. Main outcome measures: Detection and quantification of RLS. Results: Logistic regression analysis showed that RLS was significantly associated with AIS and prothrombotic disorders or with AIS of undetermined aetiology (OR 6.10; 95% CI 1.41 to 26.3; p=0.015). The prevalence of RLS was significantly higher in a group of children with AIS and prothrombotic disorders or with AIS of undetermined aetiology compared to controls (p<0.05). Significantly more microembolic signals (MES) were detected in a group of children with AIS and prothrombotic disorders or with AIS of undetermined aetiology than in controls (p<0.005). Conclusions: Both the prevalence of RLS and number of detected MES were significantly higher in a group of children with AIS and prothrombotic disorders or with AIS of undetermined aetiology compared to controls. These findings suggest that paradoxical embolism may be an underestimated cause of AIS in children, particularly those with AIS and prothrombotic disorders or with AIS of undetermined aetiology.
Deskriptorji     HEART SEPTAL DEFECTS, ATRIAL
CEREBRAL INFARCTION
EMBOLISM, PARADOXICAL
CEREBRAL ISCHEMIA
ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL
MAGNETIC RESONANCE ANGIOGRAPHY
LOGISTIC MODELS
CHILD
CHILD
VALSALVA'S MANEUVER