Diagnosis Stroke pada Anak

Oleh :

dr. Virly Isella

Diagnosis stroke pada anak yag utama adalah menentukan antara stroke iskemik atau hemoragik kemudian mencari etiologi yang mendasari. Manifestasi klinis antara stroke iskemik dan hemoragik saling tumpang tindih, sehingga perlu konfirmasi dengan magnetic resonance imaging (MRI) otak untuk menegakkan diagnosis stroke anak. Bila MRI tidak dapat segera dilakukan atau tidak tersedia, pemeriksaan computed tomography (CT scan) dapat menjadi alternatif.[1,3-6]

Anamnesis

Pada anamnesis, sulit untuk membedakan gejala yang disebabkan oleh stroke iskemik dan hemoragik, karena manifestasi klinis saling tumpang tindih. Pasien dengan stroke iskemik umumnya memiliki keluhan, berupa:

Referensi

1. Ferriero DM, Fullerton HJ, Bernard TJ, Billinghurst L, Daniels SR, DeBaun MR, et al. Management of Strokes in Neonates and Children – a Scientific Statement from the American Heart Association/ American Stroke Association. 2019.
2. Greenham M, Gordon A, Anderson V, Mackay MT. Outcome in Childhood Stroke. Stroke. 2016;47:1159-1164.
3. Klucka J, Klabusayova E, Musilova T, Kramplova T, Skrisovska T, Kratochvil M, Kosinova M, et al. Pediatric Patient with Ischemic Stroke: Initial Approach and Early Management. Children. 2021; 8.
4. Oborska Z, Urban P, Wychowaniec K, Jozwiak S. Pediatric Stroke – a Review of Current Guidelines for Diagnosis and Treatment. Polish Journal of Neurology and Neurosurgery. 2020; 54(2): 116-124.
5. Bernson-Leung ME, Rivkin MJ. Stroke in Neonates and Children. American Academy of Pediatrics. 2016; 37: 11
6. Shih EK, Beslow LA. Hemorrhagic stroke in children. 2021.
8. Asakai H, Cardamone M, Hutchinson D, Stojanovski B, Galati JC, et al. Arterial ischemic stroke in children with cardiac disease. Neurology. 2015;85(23): 2053-2059.
10. Fox C, Smith S. Ischemic stroke in children: Clinical Presentation, evaluation, and diagnosis. 2020.
13. Kliegman R. Nelson Textbook of Pediatrics 21th ed. Philadelphia, PA. Elseiver. 2020.
14. PedNIHSS. American Heart Association. 2022. https://www.ahajournals.org/action/downloadSupplement?doi=10.1161%2FSTROKEAHA.110.607192&file=607192_online_supplement.pdf
15. Tam D. Pediatric National Institutes of Health Stroke Scale (PedNIHSS). 2022.
16. Hidalgo MJ, Munoz D, Balut F, Troncoso M, Lara S, et al. Pediatric Arterial Ischemic Stroke – Clinical Presentation, Risk Factors, and Pediatric NIH Stroke Scale in a Series of Chilean Patients. Cell Med. 2018; 10.
17. Zhang Y, Parikh A, Qian S. Migraine and Stroke. Stroke Vasc Neurol. 2017; 2(3): 160-167.
18. Migraine. IHS Classification ICHD-3. 2022.
19. Warmer MJ, Hutchinson J, Varacallo M. Bell’s Palsy. StatPearls. 2021.
20. Mastriana J, Pay JL, Jesus OD, Taylor RS. Todd Paresis. StatPearls. 2021.
22. Macellari F, Paciaroni M, Agnelli G, Caso V. Neuroimaging in Intracerebral Hemorrhage. Stroke. 2014;45:903-908.
23. Sundelin H.E.K, Tomson T, Zelano J, Soderling J, Bang P, et al. Pediatric Ischemic Stroke and Epilepsy: A Nationwide Cohort Study. Stroke. AHA. 2021;52:3532-3540.
24. Fox C, Smith S. Ischemic stroke in children: clinical presentation, evaluation and diagnosis. 2022. Uptodate. https://www.uptodate.com/contents/ischemic-stroke-in-children-clinical-presentation-evaluation-and-diagnosis
25. Shih EK, Beslow LA. Hemorrhagic stroke in children. 2022. Uptodate. https://www.uptodate.com/contents/hemorrhagic-stroke-in-children
26. Ichord R. Stroke in the newborn: classification, manifestations, and diagnosis. 2021. Uptodate. https://www.uptodate.com/contents/stroke-in-the-newborn-classification-manifestations-and-diagnosis
27. Ichord R. Stroke in the newborn: management and prognosis. 2021. Uptodate. https://www.uptodate.com/contents/stroke-in-the-newborn-management-and-prognosis

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