A right-to-left shunt and prothrombotic disorders in pediatric patients presenting with transient ischemic attack
| Autor: | Mirjana Perkovič-Benedik, Tomaž Podnar, Marjan Zaletel, Nuška Pečarič-Meglič |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Septal Occluder Device Ultrasonography Doppler Transcranial Valsalva Maneuver Right-to-left shunt medicine.medical_treatment Foramen Ovale Patent Logistic regression Thrombophilia Paradoxical embolism Risk Factors medicine.artery Internal medicine Coronary Circulation mental disorders Valsalva maneuver Medicine Pediatric stroke Humans cardiovascular diseases Child business.industry medicine.disease Transcranial Doppler Logistic Models Ischemic Attack Transient Pediatrics Perinatology and Child Health Cardiology Patent foramen ovale Female business Embolism Paradoxical |
| Zdroj: | European journal of pediatrics. 172(2) |
| ISSN: | 1432-1076 |
| Popis: | Arterial ischemic stroke is an important cause of morbidity and mortality in pediatric population. A right-to-left shunt (RLS) across the patent foramen ovale was recently demonstrated as a possible risk factor for pediatric stroke. Prothrombotic disorders are frequently identified in pediatric patients with stroke. Data regarding RLS and prothrombotic disorders in pediatric patients presenting with transient ischemic attack (TIA) are lacking. The aims of the present study were (1) to compare the prevalence and grade of RLS in pediatric patients presenting with TIA vs. controls using contrast transcranial Doppler with Valsalva maneuver and (2) to identify prothrombotic disorders in pediatric patients presenting with TIA. Twenty-three consecutive pediatric patients presenting with TIA were included in the study. Logistic regression analysis showed that RLS was significantly associated with TIA (OR 4.75, 95 % CI 1.39–16.2, p = 0.013). The prevalence of RLS was significantly higher in patients in comparison to controls (p = 0.019). Significantly more microembolic signals (MES) were detected in patients than in controls (p = 0.003). Prothrombotic disorders were identified in 14 of the 23 patients. Both the prevalence of RLS and number of detected MES were significantly higher in pediatric patients presenting with TIA in comparison to controls. Prothrombotic disorders were identified in a high proportion of patients. These findings suggest that paradoxical embolism may be important in pediatric patients presenting with TIA. |
| Databáze: | OpenAIRE |
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