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Neurology Study Guide - part 9

Điều kiện khuyết tật tim bẩm sinh tim Cyanotic bẩm sinh bệnh tâm nhĩ và tâm thất vách ngăn khuyết tật sáng chế còn ống động mạch động mạch chủ và hẹp van hai lá van hai lá van sa Coarctation Acquired tim bệnh sốt thấp khớp viêm nội tâm mạc | 198 21. Pediatric Cerebrovascular Disorders ogy of brain ischemia due to embolism and thrombosis in pediatric patients. Embolic Stroke Cerebral embolism is characterized by a sudden neurological deficit that is maximal at onset and may show a partial or total improvement due to lysis and reinstatement of the perfusion. Emboli in children usually originate from the heart when congenital or acquired structural abnormalities are present. Sources of cerebral emboli in children include Cardiac sources Congenital heart defects. Cyanotic congenital heart disease. Atrial and ventricular septal defect. Coarctation of the aorta. Transposition of great vessels. Acquired heart disease. Rheumatic heart disease. Bacterial and nonbacterial endocarditis. Cardiomyopathy. Atrial myxoma. Mitral valve prolapse. Arrhythmias Atrial fibrillation occurs in children with rheumatic heart disease Ebstein s anomaly atrial septal defect and total anomalous pulmonary venous return Riela . Arterial sources Vasculopathies Moya-moya fibromuscular dysplasia. Catheterization and other procedures. Arteritis and arterial aneurysms. Trauma. Other sources Air fat embolism. Paradoxical emboli. Paradoxical Emboli and Differential Diagnosis of an Acute Focal Event Paradoxical embolization occurs when a cardiac defect allows direct entrance of embolic formations into the systemic circulation. The source of embolization derives from thrombi that form in the lower extremities or pelvic veins but also from pulmonary fistulas. Congenital heart defects such as atrial or ventricular septal defects patent foramen ovale with significant shunt truncus arteriosus and so on or large pulmonary arteriovenous fistulas that can be found in children with hereditary hemorrhagic tel-angiectasias can result in the occurrence of paradoxical embolism. In the differential diagnosis of the vignette an acute vascular event is first considered but other causes of acute focal weakness need to be presented. Space-occupying lesions .