[Stroke in children: experience of the Center for the Treatment of Cerebrovascular Diseases in Children and Adolescents in Moscow]. / Insul't u detei: opyt raboty Tsentra po lecheniyu tserebrovaskulyarnykh zabolevanii u detei i podrostkov Moskvy.

OBJECTIVE: To analyze the work of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents, operating on the basis of the Morozov Children's City Clinical Hospital of the Moscow Health Department for the period 2018-2021 and to assess the peculiarities of organizing the provision of specialized care to children and adolescents with acute cerebrovascular accident (ACA). MATERIAL AND METHODS: Annual reports of the Center for the period 2018-2021; included children and adolescents aged 1 month to 17 years 11 months 29 days, with new onset ischemic stroke (IS) and hemorrhagic stroke (HS), cerebral venous thrombosis (sinus thrombosis), confirmed clinically and radiologically. RESULTS: Statistical data on stroke and organization of care for children with this pathology in Moscow are presented. The incidence of IS in Moscow for the period 2018-2021 ranged from 1.6 to 2.5 per 100.000 children, HI - from 2.35 to 3.3 per 100.000, sinus thrombosis from 0.5 to 1.38 per 100.000. When assessing the main etiological factors of stroke in The Center for International Pediatric Stroke Research categories, we noted a prevalence of chronic head and neck diseases (20-37%) and chronic systemic conditions (conditions or diseases with known changes in coagulation or vascular structure, including connective tissue dysplasia, genetic, hematological, inflammatory or diseases of the immune system) (15-20%). In addition, data on reperfusion therapy carried out at the Center are presented. From 2018 (first thrombolysis was performed) to 2021, 7.3-14.7% of all patients with IS underwent thrombolysis. CONCLUSION: The experience of functioning of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents has shown that the creation of such centers in the regions of the Russian Federation is relevant, but requires taking into account the characteristics of the pediatric population when organizing their work.

[Stroke in children and adolescents]. / Insul't u detei i podrostkov.

OBJECTIVE: A comparative analysis of symptoms in arterial ischemic and stroke-like conditions in children, the development and analysis of the «Presumptive stroke in children¼ scale for prehospital diagnosis of ischemic strokes in children. MATERIAL AND METHODS: This article analyzes cases of emergency hospitalization of children in a stroke center with suspected cerebrovascular pathology as well as the symptoms of patients with suspected ischemic stroke, compares the leading and final diagnoses, identifies the main «mimics¼ of stroke and their symptom complexes. A comparison of the obtained data with the results of previous studies was carried out. RESULTS: The results show the prevalence of motor disorders and coordination disorders in cases of ischemic stroke and cerebral symptoms in cases of stroke-like conditions in children. The most frequent stroke-mimic is migraine. Based on the results of the study, we propose a screening scale for pre-hospital diagnosis of ischemic stroke in children. A preliminary assessment of the effectiveness of the scale using examples of cases of confirmed stroke and stroke-mimic was performed. CONCLUSION: Timely hospitalization of children with stroke can not only reduce mortality, but also use modern diagnostic and treatment methods to reduce the volume of brain damage with a possible complete restoration of motor and cognitive functions. Further analysis of the sensitivity and specificity of the «Presumptive stroke in children¼ scale is required.

[Formation and Unique Experience of the Center For the Treatment of Cerebrovascular Pathology in Children and Adolescents Located in a Multidisciplinary Pediatric Hospital, as the Only Primary Center of Pediatric Stroke in the Russian Federation].

Stroke is in the top ten causes of children death, ahead of brain tumors. Х-ray diagnostics development has significantly improved the detectability of pediatric stroke. The average incidence of cerebrovascular diseases in children was 13 per 100,000 children annually. The main feature of children's stroke is its multifactorial character, which complicates diagnostic process and requires involvement of doctors of different specialties to determine the leading etiological factors and choose optimal therapy and management tactics. The Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents was established on the basis of Morozov Children City Clinical Hospital by Moscow Healthcare Department, Order No. 169, dated February 27, 2014. The main task was to create a pediatric stroke center on the basis of multidisciplinary Morozov Children City Clinical Hospital, which met the main international requirements of the primary center for pediatric stroke. It was done to improve early diagnostic process, refine the algorithm for maintaining patient data in acute periods, develop preventive measures, maintain city pediatric stroke register, introduce family consultations, coordinate medical care for children with cerebrovascular pathology at various levels in Moscow, and improve medical care quality for children with cerebrovascular pathology and their families. Since April 2014 more than 800 children have undergone inpatient treatment and more than 420 have been treated in outpatient departments of Morozov Children City Clinical Hospital.