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Darteyre S, Renaud C, Fluss J, Laporte S, Bertoletti L, Chabrier S. Secondary Prevention of Childhood Arterial Ischemic Stroke. J Child Neurol 2017; 32:488-493. [PMID: 28128037 DOI: 10.1177/0883073816686911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to know how frontline physicians in France, Belgium, and Switzerland implement guidelines regarding the secondary prevention of childhood arterial ischemic stroke and to introduce physicians' point of view on a clinical trial assessing the efficacy of aspirin as a preventive strategy. The authors conducted an online survey directed at specialists throughout dedicated networks and used a mixed method for data analysis. Overall, 63 physicians responded, and 88% prescribe aspirin when sickle cell disease, cardio-embolic stroke, and dissection of cervical arteries are excluded. Prescribing habits vary among respondents with respect to their specialty. A majority would choose placebo or a treatment given to historical controls to compare with an aspirin arm in a trial. In studied countries, there seems to be good adherence to guidelines regarding the secondary prevention of childhood stroke. A trial assessing the efficacy of aspirin could be well accepted if several factors regarding study design were taken into account.
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Affiliation(s)
- Stéphane Darteyre
- 1 INSERM, UMR 1059, SAINBIOSE, Dysfonction Vasculaire et Hémostase, Université Jean Monnet, Saint-Étienne, France
| | - Cyrille Renaud
- 2 CHU Saint-Étienne, French Center for Pediatric stroke and Pediatric Rehabilitation Unit, Saint-Étienne, France
| | - Joel Fluss
- 3 Pediatric Neurology Unit, Children's Hospital, Geneva, Switzerland
| | - Silvy Laporte
- 1 INSERM, UMR 1059, SAINBIOSE, Dysfonction Vasculaire et Hémostase, Université Jean Monnet, Saint-Étienne, France.,4 CHU Saint-Étienne, Unité de Recherche Clinique, Innovation, Pharmacologie, Hôpital Nord, Saint-Étienne France
| | - Laurent Bertoletti
- 1 INSERM, UMR 1059, SAINBIOSE, Dysfonction Vasculaire et Hémostase, Université Jean Monnet, Saint-Étienne, France.,5 INSERM, CIC1408, Saint-Étienne, France.,6 CHU Saint-Étienne, Service de Médecine Vasculaire et Thérapeutique, Hôpital Nord, Saint-Étienne, France
| | - Stéphane Chabrier
- 1 INSERM, UMR 1059, SAINBIOSE, Dysfonction Vasculaire et Hémostase, Université Jean Monnet, Saint-Étienne, France.,2 CHU Saint-Étienne, French Center for Pediatric stroke and Pediatric Rehabilitation Unit, Saint-Étienne, France.,5 INSERM, CIC1408, Saint-Étienne, France
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2
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[Diagnosis and emergency treatment of stroke in children]. SOINS. PÉDIATRIE, PUÉRICULTURE 2017; 38:14-16. [PMID: 28325379 DOI: 10.1016/j.spp.2017.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The sudden occurrence of a focal neurological deficit, sometimes transitory and fluctuating, must lead to a suspicion of a stroke, including in a child. The preferred examination is magnetic resonance imaging with magnetic resonance angiography in an emergency. The sequelae of stroke are common and severe. Urgent diagnosis and adapted care can help to improve morbidity-mortality. Rehabilitation starts early and must systematically screen for cognitive or language impairment. The management of a stroke in a child must be planned for in multi-disciplinary protocols established before the patient's arrival at hospital.
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Hubert A, Curie A, Sabatier I, Poulat AL, Carneiro M, Chabrier S. [Transient ischemic attack: as well a paediatric emergency]. Presse Med 2015; 44:249-51. [PMID: 25555829 DOI: 10.1016/j.lpm.2014.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/26/2014] [Accepted: 06/29/2014] [Indexed: 01/13/2023] Open
Affiliation(s)
- Anna Hubert
- Hospices civils de Lyon, hôpital femme-mère-enfant, service de neuropédiatrie, 69677 Bron, France
| | - Aurore Curie
- Hospices civils de Lyon, hôpital femme-mère-enfant, service de neuropédiatrie, 69677 Bron, France
| | - Isabelle Sabatier
- Hospices civils de Lyon, hôpital femme-mère-enfant, service de neuropédiatrie, 69677 Bron, France
| | - Anne Lise Poulat
- Hospices civils de Lyon, hôpital femme-mère-enfant, service de neuropédiatrie, 69677 Bron, France
| | - Maryline Carneiro
- Hospices civils de Lyon, hôpital femme-mère-enfant, service de neuropédiatrie, 69677 Bron, France
| | - Stéphane Chabrier
- CHU de Saint-Étienne, hôpital Bellevue, Centre national de référence de l'AVC de l'enfant, 42055 Saint-Étienne, France.
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Management and 2-year follow-up of children aged 29days to 17years hospitalized for a first stroke in France (2009–2010). Arch Pediatr 2014; 21:1305-15. [DOI: 10.1016/j.arcped.2014.08.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/13/2014] [Accepted: 08/20/2014] [Indexed: 11/16/2022]
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Reis AF, Pais P, Monteiro JP. Chickenpox and stroke in children: case studies and literature review. Acta Paediatr 2014; 103:e176-80. [PMID: 24330378 DOI: 10.1111/apa.12535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/09/2013] [Accepted: 12/06/2013] [Indexed: 12/21/2022]
Abstract
UNLABELLED Postvaricella cerebral arteriopathy (PVCA) presents with acute haemiparesis and/or haemidistonia, caused by ischaemic lesions of internal capsule and/or basal ganglia, related to stenosis of proximal middle and/or anterior cerebral arteries. Anti-aggregant drugs are recommended to prevent thrombus expansion and recurrent stroke, but neurologic outcome is usually good regardless of the therapeutic approach. CONCLUSION Chickenpox should be considered in differential diagnosis of ischaemic stroke in healthy children who fit the clinical and radiological typical profile of PVCA.
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Affiliation(s)
- Ana F Reis
- Department of Paediatrics; Hospital Garcia de Orta; Almada Portugal
| | - Patrícia Pais
- Department of Paediatrics; Hospital Garcia de Orta; Almada Portugal
| | - José P Monteiro
- Department of Paediatrics; Hospital Garcia de Orta; Almada Portugal
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Thérapeutique antithrombotique : quelles modifications avec les nouveaux anticoagulants oraux ? Presse Med 2013; 42:1204-5. [DOI: 10.1016/j.lpm.2013.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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