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The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study: A Population-Based Study
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| Zeitschriftentitel: | Stroke |
|---|---|
| Personen und Körperschaften: | , , , , |
| In: | Stroke, 40, 2009, 2, S. 400-405 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
Jordan, Lori C. Johnston, S. Claiborne Wu, Yvonne W. Sidney, Stephen Fullerton, Heather J. Jordan, Lori C. Johnston, S. Claiborne Wu, Yvonne W. Sidney, Stephen Fullerton, Heather J. |
|---|---|
| author |
Jordan, Lori C. Johnston, S. Claiborne Wu, Yvonne W. Sidney, Stephen Fullerton, Heather J. |
| spellingShingle |
Jordan, Lori C. Johnston, S. Claiborne Wu, Yvonne W. Sidney, Stephen Fullerton, Heather J. Stroke The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) |
| author_sort |
jordan, lori c. |
| spelling |
Jordan, Lori C. Johnston, S. Claiborne Wu, Yvonne W. Sidney, Stephen Fullerton, Heather J. 0039-2499 1524-4628 Ovid Technologies (Wolters Kluwer Health) Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) http://dx.doi.org/10.1161/strokeaha.108.518761 <jats:p> <jats:bold> <jats:italic>Background and Purpose—</jats:italic> </jats:bold> Prior population-based studies of pediatric hemorrhagic stroke (HS) had too few incident cases to assess predictors of cerebral aneurysms, a HS etiology that requires urgent intervention. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods—</jats:italic> </jats:bold> We performed a retrospective cohort study of HS (intracerebral, subarachnoid [SAH], and intraventricular hemorrhage) using the population of all children <20 years of age enrolled in a large Northern Californian healthcare plan (January 1993 to December 2003). Cases were identified through electronic searches and confirmed through independent chart review by 2 neurologists with adjudication by a third; traumatic hemorrhages were excluded. Logistic regression was used to examine potential predictors of underlying aneurysm. </jats:p> <jats:p> <jats:bold> <jats:italic>Results—</jats:italic> </jats:bold> Within a cohort of 2.3 million children followed for a mean of 3.5 years, we identified 116 cases of spontaneous HS (overall incidence, 1.4 per 100000 person-years). Cerebral aneurysms were identified in 15 (13%) of HS cases. Among 21 children with pure SAH, 57% were found to have an underlying aneurysm compared with only 2% of 58 children with pure intracerebral hemorrhage and 5% of 37 children with a mixed pattern of hemorrhage (intracerebral hemorrhage and SAH). Independent predictors of an underlying aneurysm included pure SAH (OR, 76; 95% CI, 9 to 657; <jats:italic>P</jats:italic> <0.001) and late adolescent age (15 to 19 years versus younger age groups; OR, 6.4; 95% CI, 1.0 to 40; <jats:italic>P</jats:italic> =0.047). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Cerebral aneurysms cause the majority of spontaneous SAH in children and account for more than 10% of childhood HS overall. Children, and particularly teenagers, presenting with spontaneous SAH should be promptly evaluated with cerebrovascular imaging. </jats:p> A Population-Based Study The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study Stroke |
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10.1161/strokeaha.108.518761 |
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Ovid Technologies (Wolters Kluwer Health), 2009 |
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Ovid Technologies (Wolters Kluwer Health), 2009 |
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0039-2499 1524-4628 |
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ai |
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Stroke |
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49 |
| title_sub |
A Population-Based Study |
| title |
The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_unstemmed |
The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_full |
The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_fullStr |
The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_full_unstemmed |
The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_short |
The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_sort |
the importance of cerebral aneurysms in childhood hemorrhagic stroke : a population-based study |
| topic |
Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) |
| url |
http://dx.doi.org/10.1161/strokeaha.108.518761 |
| publishDate |
2009 |
| physical |
400-405 |
| description |
<jats:p>
<jats:bold>
<jats:italic>Background and Purpose—</jats:italic>
</jats:bold>
Prior population-based studies of pediatric hemorrhagic stroke (HS) had too few incident cases to assess predictors of cerebral aneurysms, a HS etiology that requires urgent intervention.
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Methods—</jats:italic>
</jats:bold>
We performed a retrospective cohort study of HS (intracerebral, subarachnoid [SAH], and intraventricular hemorrhage) using the population of all children <20 years of age enrolled in a large Northern Californian healthcare plan (January 1993 to December 2003). Cases were identified through electronic searches and confirmed through independent chart review by 2 neurologists with adjudication by a third; traumatic hemorrhages were excluded. Logistic regression was used to examine potential predictors of underlying aneurysm.
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Results—</jats:italic>
</jats:bold>
Within a cohort of 2.3 million children followed for a mean of 3.5 years, we identified 116 cases of spontaneous HS (overall incidence, 1.4 per 100000 person-years). Cerebral aneurysms were identified in 15 (13%) of HS cases. Among 21 children with pure SAH, 57% were found to have an underlying aneurysm compared with only 2% of 58 children with pure intracerebral hemorrhage and 5% of 37 children with a mixed pattern of hemorrhage (intracerebral hemorrhage and SAH). Independent predictors of an underlying aneurysm included pure SAH (OR, 76; 95% CI, 9 to 657;
<jats:italic>P</jats:italic>
<0.001) and late adolescent age (15 to 19 years versus younger age groups; OR, 6.4; 95% CI, 1.0 to 40;
<jats:italic>P</jats:italic>
=0.047).
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Conclusions—</jats:italic>
</jats:bold>
Cerebral aneurysms cause the majority of spontaneous SAH in children and account for more than 10% of childhood HS overall. Children, and particularly teenagers, presenting with spontaneous SAH should be promptly evaluated with cerebrovascular imaging.
</jats:p> |
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| author | Jordan, Lori C., Johnston, S. Claiborne, Wu, Yvonne W., Sidney, Stephen, Fullerton, Heather J. |
| author_facet | Jordan, Lori C., Johnston, S. Claiborne, Wu, Yvonne W., Sidney, Stephen, Fullerton, Heather J., Jordan, Lori C., Johnston, S. Claiborne, Wu, Yvonne W., Sidney, Stephen, Fullerton, Heather J. |
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| description | <jats:p> <jats:bold> <jats:italic>Background and Purpose—</jats:italic> </jats:bold> Prior population-based studies of pediatric hemorrhagic stroke (HS) had too few incident cases to assess predictors of cerebral aneurysms, a HS etiology that requires urgent intervention. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods—</jats:italic> </jats:bold> We performed a retrospective cohort study of HS (intracerebral, subarachnoid [SAH], and intraventricular hemorrhage) using the population of all children <20 years of age enrolled in a large Northern Californian healthcare plan (January 1993 to December 2003). Cases were identified through electronic searches and confirmed through independent chart review by 2 neurologists with adjudication by a third; traumatic hemorrhages were excluded. Logistic regression was used to examine potential predictors of underlying aneurysm. </jats:p> <jats:p> <jats:bold> <jats:italic>Results—</jats:italic> </jats:bold> Within a cohort of 2.3 million children followed for a mean of 3.5 years, we identified 116 cases of spontaneous HS (overall incidence, 1.4 per 100000 person-years). Cerebral aneurysms were identified in 15 (13%) of HS cases. Among 21 children with pure SAH, 57% were found to have an underlying aneurysm compared with only 2% of 58 children with pure intracerebral hemorrhage and 5% of 37 children with a mixed pattern of hemorrhage (intracerebral hemorrhage and SAH). Independent predictors of an underlying aneurysm included pure SAH (OR, 76; 95% CI, 9 to 657; <jats:italic>P</jats:italic> <0.001) and late adolescent age (15 to 19 years versus younger age groups; OR, 6.4; 95% CI, 1.0 to 40; <jats:italic>P</jats:italic> =0.047). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Cerebral aneurysms cause the majority of spontaneous SAH in children and account for more than 10% of childhood HS overall. Children, and particularly teenagers, presenting with spontaneous SAH should be promptly evaluated with cerebrovascular imaging. </jats:p> |
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| imprint_str_mv | Ovid Technologies (Wolters Kluwer Health), 2009 |
| institution | DE-D275, DE-Bn3, DE-Brt1, DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4, DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1, DE-L229 |
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| spelling | Jordan, Lori C. Johnston, S. Claiborne Wu, Yvonne W. Sidney, Stephen Fullerton, Heather J. 0039-2499 1524-4628 Ovid Technologies (Wolters Kluwer Health) Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical) http://dx.doi.org/10.1161/strokeaha.108.518761 <jats:p> <jats:bold> <jats:italic>Background and Purpose—</jats:italic> </jats:bold> Prior population-based studies of pediatric hemorrhagic stroke (HS) had too few incident cases to assess predictors of cerebral aneurysms, a HS etiology that requires urgent intervention. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods—</jats:italic> </jats:bold> We performed a retrospective cohort study of HS (intracerebral, subarachnoid [SAH], and intraventricular hemorrhage) using the population of all children <20 years of age enrolled in a large Northern Californian healthcare plan (January 1993 to December 2003). Cases were identified through electronic searches and confirmed through independent chart review by 2 neurologists with adjudication by a third; traumatic hemorrhages were excluded. Logistic regression was used to examine potential predictors of underlying aneurysm. </jats:p> <jats:p> <jats:bold> <jats:italic>Results—</jats:italic> </jats:bold> Within a cohort of 2.3 million children followed for a mean of 3.5 years, we identified 116 cases of spontaneous HS (overall incidence, 1.4 per 100000 person-years). Cerebral aneurysms were identified in 15 (13%) of HS cases. Among 21 children with pure SAH, 57% were found to have an underlying aneurysm compared with only 2% of 58 children with pure intracerebral hemorrhage and 5% of 37 children with a mixed pattern of hemorrhage (intracerebral hemorrhage and SAH). Independent predictors of an underlying aneurysm included pure SAH (OR, 76; 95% CI, 9 to 657; <jats:italic>P</jats:italic> <0.001) and late adolescent age (15 to 19 years versus younger age groups; OR, 6.4; 95% CI, 1.0 to 40; <jats:italic>P</jats:italic> =0.047). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Cerebral aneurysms cause the majority of spontaneous SAH in children and account for more than 10% of childhood HS overall. Children, and particularly teenagers, presenting with spontaneous SAH should be promptly evaluated with cerebrovascular imaging. </jats:p> A Population-Based Study The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study Stroke |
| spellingShingle | Jordan, Lori C., Johnston, S. Claiborne, Wu, Yvonne W., Sidney, Stephen, Fullerton, Heather J., Stroke, The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study, Advanced and Specialized Nursing, Cardiology and Cardiovascular Medicine, Neurology (clinical) |
| title | The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_full | The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_fullStr | The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_full_unstemmed | The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_short | The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| title_sort | the importance of cerebral aneurysms in childhood hemorrhagic stroke : a population-based study |
| title_sub | A Population-Based Study |
| title_unstemmed | The Importance of Cerebral Aneurysms in Childhood Hemorrhagic Stroke : A Population-Based Study |
| topic | Advanced and Specialized Nursing, Cardiology and Cardiovascular Medicine, Neurology (clinical) |
| url | http://dx.doi.org/10.1161/strokeaha.108.518761 |