Sunday, February 21, 2010

Introduction:

Sadly, children with CHD'S (Congenital Heart Defects) are prone to many complications. One of those complications, is a STROKE.
I hope to find more up to date information on this subject.
HERE IS SOME INFORMATION I FOUND ON STROKES IN CARDIAC KIDS:

John Kylan Lynch, DO, MPH writes:
Cardiac disorders, identified in up to 50% of strokes in
case series, are the most common risk factor for stroke in
children . In the Canadian Pediatric Ischemic Stroke
Registry (CPISR) , cardiac disease was identified in 25%
of children with AIS. Cardiac disorders were the most common
risk factor among children hospitalized with AIS in
the United States from 1979 to 2000 (27% of all cases).
Several cardiac disorders are associated with stroke in children:
congenital heart disease, intracardiac defects, cardiac
procedures, and acquired heart disease. Cardiac disorders
can lead to the development of intracardiac thrombi that
may embolize to the brain or can lead to thrombosis in
cyanotic patients with anemia.
Congenital heart disease
(CHD) was the most common risk factor among children
hospitalized with stroke in California from 1991 to
2000. The incidence of CHD is one per 100 live births.
In the United States, early treatment and improved
surgical techniques for cardiac disorders have increased
survival rates and reduced cerebrovascular events: the
percentage of ischemic strokes due to cardiac disorders
decreased 76% among children hospitalized with ischemic
stroke between the years 1979 and 2000 [8].

http://en.wikipedia.org/wiki/Stroke
A stroke (sometimes called a cerebrovascular accident (CVA)) is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain, caused by a blocked or burst blood vessel. This can be due to ischemia (lack of glucose and oxygen supply) caused by thrombosis or embolism or due to a hemorrhage.[1] As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field.[2]

http://pediatrics.aappublications.org/cgi/content/full/122/6/1292
ACCORDING TO THE OFFICIAL JOURNAL OF THE AMERICAN ACADEMY OF PEDIATRICS:
Published online December 1, 2008 PEDIATRICS Vol. 122 No. 6 December 2008, pp. 1292-1298 (doi:10.1542/peds.2007-1459)
ARTICLE
Frequency, Predictors, and Neurologic Outcomes of Vaso-occlusive Strokes Associated With Cardiac Surgery in Children
OBJECTIVE. Our aim was to define the frequency, predictors, and outcomes of stroke associated with cardiac surgery in children with congenital heart disease.
CONCLUSIONS. The frequency of vaso-occlusive stroke in children with congenital heart disease undergoing cardiac surgery was 5.4 cases per 1000 children. Age, duration of bypass, and reoperation may be associated with stroke risk.
The incidence rate of stroke after cardiac surgery among children with CHD was 5.4 cases per 1000 operations. Although this is likely an underestimate, it has important implications. Our study had insufficient power to identify predictors of stroke and potential preventative strategies. Ongoing research should continue toward improvements in intraoperative and postoperative management aimed at preventing neurologic morbidity.



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