背景:脑血管疾病是儿童发病和死亡的重要原因。对缺血性或出血性中风或脑窦静脉血栓形成的儿童的急性护理侧重于稳定患者,确定侮辱的原因,防止二次伤害。这里,我们回顾了有创和无创神经监测模式在动脉缺血性卒中儿科患者护理中的应用。非创伤性颅内出血,和脑窦静脉血栓形成。
方法:关于脑血管病患儿神经监测的文献综述。
结果:神经影像学,近红外光谱,经颅多普勒超声检查,连续和定量脑电图,有创颅内压监测,多模式神经监测可能会增强脑血管疾病患儿的急性护理。神经监测可以在早期识别动脉缺血性中风后的演变损伤中起重要作用。颅内出血,或静脉窦血栓形成,包括复发性梗死或梗死扩大,新的或复发性出血,血管痉挛和迟发性脑缺血,癫痫持续状态,颅内高压,其中,而这个,是转身,可以促进对治疗计划的实时调整。
结论:在过去的几年中,我们对小儿脑血管疾病的了解急剧增加,部分原因是神经监测模式的进步,使我们能够更好地了解这些情况。我们现在蓄势待发,作为一个领域,利用神经监测能力的进步来确定如何最好地管理和治疗儿童急性脑血管疾病。
Cerebrovascular disorders are an important cause of morbidity and mortality in children. The acute care of a child with an ischemic or hemorrhagic stroke or cerebral sinus venous thrombosis focuses on stabilizing the patient, determining the cause of the insult, and preventing secondary injury. Here, we review the use of both invasive and noninvasive neuromonitoring modalities in the care of pediatric patients with arterial ischemic stroke, nontraumatic intracranial hemorrhage, and cerebral sinus venous thrombosis.
Narrative review of the literature on neuromonitoring in children with cerebrovascular disorders.
Neuroimaging, near-infrared spectroscopy, transcranial Doppler ultrasonography, continuous and quantitative electroencephalography, invasive intracranial pressure monitoring, and multimodal neuromonitoring may augment the acute care of children with cerebrovascular disorders. Neuromonitoring can play an essential role in the early identification of evolving injury in the aftermath of arterial ischemic stroke, intracranial hemorrhage, or sinus venous thrombosis, including recurrent infarction or infarct expansion, new or recurrent hemorrhage, vasospasm and delayed cerebral ischemia, status epilepticus, and intracranial hypertension, among others, and this, is turn, can facilitate real-time adjustments to treatment plans.
Our understanding of pediatric cerebrovascular disorders has increased dramatically over the past several years, in part due to advances in the neuromonitoring modalities that allow us to better understand these conditions. We are now poised, as a field, to take advantage of advances in neuromonitoring capabilities to determine how best to manage and treat acute cerebrovascular disorders in children.