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Thromb Haemost 2015; 113(06): 1270-1277
DOI: 10.1160/TH14-05-0431
Coagulation and Fibrinolysis
Schattauer GmbH

Paediatric arterial ischaemic stroke and cerebral sinovenous thrombosis

First report from the Italian Registry of Pediatric Thrombosis (R. I. T. I., Registro Italiano Trombosi Infantili)
Agnese Suppiej
1   Child Neurology Unit, Pediatric University Hospital of Padua, Padua, Italy
,
Chiara Gentilomo
2   Department of Pediatrics, Dell’Angelo Hospital, Venice, Italy
,
Paola Saracco
3   Pediatric Hematology and Oncology, University of Turin, Hospital Regina Margherita Turin, Italy
,
Stefano Sartori
1   Child Neurology Unit, Pediatric University Hospital of Padua, Padua, Italy
,
Manuela Agostini
4   Department of Pediatrics, University of Turin, Hospital Regina Margherita Turin, Italy
,
Rossana Bagna
4   Department of Pediatrics, University of Turin, Hospital Regina Margherita Turin, Italy
,
Bianca Bassi
5   Child Neuropsichiatry, University of Turin, Hospital Regina Margherita Turin, Italy
,
Paola Giordano
6   Pediatric Hematology and Oncology, University of Bari, Italy
,
Massimo Grassi
6   Pediatric Hematology and Oncology, University of Bari, Italy
,
Andrea Guzzetta
7   Department of Developmental Neurosciences, IRCCS Stella Maris, Pisa, Italy
,
Donatella Lasagni
9   Department of Hematology and Oncology and Transfusional Medicine, IRCCS Pediatric Hospital Bambin Gesù, Rome, Italy
,
Matteo Luciani
9   Department of Hematology and Oncology and Transfusional Medicine, IRCCS Pediatric Hospital Bambin Gesù, Rome, Italy
,
Angelo C. Molinari
10   Thrombosis and Hemostasis Unit, Department of Hematology and Oncology, IRCCS Giannina Gaslini, Genoa, Italy
,
Antonella Palmieri
11   Department of Pediatric Emergency, IRCCS Giannina Gaslini, Genoa, Italy
,
Maria Caterina Putti
12   Department of Oncology and Hematology, University Hospital of Padua, Padua, Italy
,
Luca Antonio Ramenghi
13   Neonatal Intensive Care Unit, IRCCS Gaslini Institute, Genoa, Italy
,
Lidia Luciana Rota
14   Cardiovascular Prevention Center, Humanitas Research Hospital, Milan, Italy
,
Domenico Sperlì
15   Pediatric Department, Annunziata Hospital, Cosenza, Italy
,
Anna Maria Laverda
1   Child Neurology Unit, Pediatric University Hospital of Padua, Padua, Italy
,
Paolo Simioni
16   Department of Medicine, Coagulation Diseases Unit, University of Padua Medical School, Padua, Italy
,
the Stroke working group of the R. I. T. I. (Registro Italiano Trombosi Infantili) › Author Affiliations
Further Information

Publication History

Received: 13 May 2014

Accepted after major revision: 14 January 2015

Publication Date:
22 November 2017 (online)

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Summary

Data from large case series of children with cerebral thrombotic events are pivotal to improve prevention, early recognition and treatment of these conditions. The Italian Registry of Pediatric Thrombosis (R. I. T. I.) was established in 2007 by a multidisciplinary team, aiming for a better understanding of neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols. We analysed data relative to the paediatric cerebral thrombotic events of the R. I. T. I. which occurred between January 2007 and June 2012. In the study period, 79 arterial ischaemic stroke (AIS) events (49 in males) and 91 cerebral sinovenous thrombosis (CSVT) events (65 in males) were enrolled in the R. I. T. I. Mean age at onset was 4.5 years in AIS, and 7.1 years in CSVT. Most common modes of presentation were hemiparesis, seizures and speech disturbances in AIS, and headache, seizures and lethargy in CSVT. Most common etiologies were underlying chronic diseases, vasculopathy and cardiopathy in AIS, and underlying chronic diseases and infection in CSVT. Time to diagnosis exceeded 24 hours in 46 % AIS and 59 % CSVT. Overall data from the Italian Registry are in substantial agreement with those from the literature, despite small differences. Among these, a longer time to diagnosis compared to other registries and case series poses the accent to the need of an earlier recognition of paediatric cerebrovascular events in Italy, in order to enable prompt and effective treatment strategies.

Keywords

Thrombosis - AIS - CSVT - children - registry - Italy

 

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