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Rehabilitation Practice and Science

Translated Title

兒童動脈缺血性腦中風之復健成效及預後：病例報告

Abstract

The incidence of ischemic stroke in childhood is two to 13 per 100,000 children per year. Although the incidence is much lower than adults, strokes in children not only cause a large number of deaths, but also induce significant disabilities. Because childhood ischemic strokes are rare, multi center, controlled trials should be performed to provide evidence based data related to effectiveness of medical treatment and rehabilitation. Current studies on the management of stroke in children are mainly based on casereports, uncontrolled trials, or are adapted from adult literature.An eleven-year-old, obese boy presented to the Emergency Department with an initial presentation of sudden onset right sided limb weakness, unsteady gait, and slurred speech. Muscle strength on the right side was grade Ⅳ, but rapidly decreased to grade Ⅰ over the following two days. Brain MRI revealed left internal capsule infarct. No other etiological or risk factors could be identified. The boy received treatment with oral aspirin. Low molecular weight heparin injection was also given for ten days. No significant side effects occurred during the treatment. A comprehensive rehabilitation program started on the tenth day after stroke onset. After comprehensive rehabilitation for 6 months, the patient's gait pattern and muscle strength recovered to near normal. Recovery of motor function was quite remarkable. His intelligence measured by WISC-Ⅲ indicated that his total IQ was 82. Although the IQ level was in the range of the lower normal limit, the boy returned to his original school, and had fair academic performance. Previously it was thought that children with strokes recover better than adults due to a higher development potential of the immature brain, but this concept was not evidence based. An increasing number of studies have analyzed motor, cognitive and behavior impairments after stroke in childhood. This article discusses the etiology, specific medical treatment, rehabilitation and prognosis of arterial ischemic stroke in childhood. Related articles were also reviewarticleed and compared to our case.

Language

Traditional Chinese

First Page

105

Last Page

110

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