ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <!-- saved from url=(0041)file://\\Nazi\e\sol-end\eng-maghale-2.htm --> <HTML><HEAD> <meta http-equiv="Content-Language" content="en-us"> <TITLE>Professor Soltanzadeh</TITLE> <META http-equiv=Content-Type content="text/html; charset=unicode"> <META content="Microsoft FrontPage 5.0" name=GENERATOR> <META content=FrontPage.Editor.Document name=ProgId></HEAD> <BODY text=#000000 vLink=#ff0000 aLink=#0000ff link=#0000ff bgProperties=fixed bgColor=#ffffff leftMargin=0 background="foriegnarticle2_files/bg4 copy.gif" topMargin=0> <DIV align=left> <TABLE height=61 cellSpacing=0 cellPadding=0 width=706 border=0> <TBODY> <TR> <TD vAlign=bottom align=justify width=166 height=1><IMG height=140 src="foriegnarticle2_files/toppage3.gif" width=166 border=0></TD> <TD width=673 background=foriegnarticle2_files/bgew.gif height=1> <DIV align=left> <TABLE height=136 cellSpacing=0 cellPadding=0 border=0 width="613"> <TBODY> <TR> <TD colSpan=4 height=46 width="290"> <P align=center><IMG height=36 src="foriegnarticle2_files/Toptext7.gif" width=255 border=0></P></TD> <TD height=46 width="50"></TD> <TD height=46 width="45"></TD> <TD height=46 width="120"></TD> <TD colSpan=2 height=46 width="118"><IMG height=40 src="foriegnarticle2_files/inkscroll.gif" width=65 align=right border=0></TD></TR> <TR> <TD height=36 width="40"><a href="tamas.htm"><IMG height=30 src="foriegnarticle2_files/But8copy.gif" width=40 border=0></a></TD> <TD height=36 width="80"><a href="karhay.htm"><IMG height=30 src="foriegnarticle2_files/But7copy.gif" width=80 border=0></a></TD> <TD height=36 width="115"><a href="tarh.htm"><IMG height=30 src="foriegnarticle2_files/b1.gif" width=115 border=0></a></TD> <TD height=36 width="55"><a href="maghale.htm"><IMG height=30 src="foriegnarticle2_files/b2.gif" width=55 border=0></a></TD> <TD height=36 width="50"><a href="kongereh.htm"><IMG height=30 src="foriegnarticle2_files/But4copy.gif" width=50 border=0></a></TD> <TD height=36 width="45"><a href="talifat.htm"><IMG height=30 src="foriegnarticle2_files/But3copy.gif" width=45 border=0></a></TD> <TD height=36 width="120"><a href="moarefi.htm"><IMG height=30 src="foriegnarticle2_files/But1copy.gif" width=120 border=0></a></TD> <TD vAlign=bottom height=36 width="84"><a href="index.htm"><IMG height=30 src="foriegnarticle2_files/But10copy.gif" width=80 border=0></a>&nbsp;</TD> <TD height=36 width="34">&nbsp;&nbsp;&nbsp;&nbsp;</TD></TR> <TR> <TD align=left colSpan=9 height=54 width="623"> <p class="MsoTitle"><b><font size="4">Stroke in Children : Recognition,Treatment,and Future Directions</font></b></TD></TR></TBODY></TABLE></DIV></TD></TR> <TR> <TD vAlign=top align=justify width=166 height=180><IMG height=174 src="foriegnarticle2_files/toppage1.gif" width=114 align=top border=0></TD> <TD width=673 height=180> <DIV align=left> <TABLE cellSpacing=0 cellPadding=4 width=587> <TBODY> <TR> <TD width="579"> <p class="MsoBodyText"><font color="#000080"><br> <br> Gabrielle de Veber , E.Steve Roach , Anthony R. Riela , and Max&nbsp; Wiznitzer</font><TR> <TD width="579"> <p class="MsoNormal" style="text-align:justify;direction:ltr;unicode-bidi:embed"> <br> &nbsp;&nbsp;&nbsp;&nbsp; Childhood stoke is increasingly recognized , but studies remain largly descriptive . Important differences from adult stroke include the following: (1) frequently delayed or missed diagnosis,(2) heterogenous and overlapping risk factors , and (3) developmental differences in the cerebrovascular , neurologic , and coagulation systems . These aspects limit the extrapolation of the results of adult stroke research and present challenges in caring for children with stroke . The incidence of childhood ischemic stroke exceeds 3.3 in 100,000 children per year , more than double the estimates from past decades . The increased incidence reflects,&nbsp; in part , increased survival in previously fatal conditions predisposing to stroke , including congenital heart disease , stickle cell anemia , and leukemia . Risk factors for stroke are recognized in more than 75% of children . Common risk factors include congenital heart disease and sickle cell disease . Progressive arteriopathies , including vasculitis and moyamoya syndrome , are rate in children with stroke ; however , transient arteriopathies including post-varicella angiopathy are increasingly recognized . Prothrombotic abnormalities are frequently present but of unclear significance. Adverse outcomes after childhood stroke , including death in 10% , recurrence in 20% , and neurologic deficits in two thirds of survivors could be reduced with available stroke treatments . Aggressive prehospital emergency care and transfer could improve access to hupeacute stroke therapies including tPA . Currently , the diagnosis is delayed by more than 24 hours from onset in most children . As in adults , tPA will likely produce unacceptable rates of intracerebral hemmorrhage unless given within 3 hours of stroke symptom onset. The appropriate choices for in hospital treatment and secondary preventative strategies , including aspitin and anticoagulants , are controversial.Empiric recommendations are published; however , age-appropriate clinical trials are urgently needed .The large multiational networks of investigators necessary for designing and conducting these future trials are now being formed.</p> <hr> <p class="MsoNormal" style="DIRECTION: ltr; TEXT-ALIGN: justify; unicode-bidi: embed"> <font color="#008000"><b>Journal of Child Neurology</b></font></TR></TBODY></TABLE> <p> <font color="#800000">Copyright©&nbsp; 2000 by W.B.Saunders Company</font></DIV> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed"><font color="#008000">Seminars in Pediatric Neurology,Vol 7, No 4 (December), 2000:pp 309-317</font><BR> </p> <DIV align=left> <TABLE height=67 cellSpacing=0 cellPadding=0 width=599 border=0> <TBODY> <TR> <TD width=579 height=65> <P class=MsoNormal dir=rtl style="MARGIN-BOTTOM: -15px; DIRECTION: rtl; unicode-bidi: embed; mso-pagination: none; mso-layout-grid-align: none" align=center><A href="file://Nazi/e/sol-end/Index.htm">Home page</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/eng-moarefi.htm">Introduction</A>&nbsp;|&nbsp;<A href="file://Nazi/e/sol-end/eng-tarh.htm"> Research Studies</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/eng-talifat.htm"> Editorships</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/eng-translate.htm"> Translations</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/eng-kongereh.htm"> Conferences</A>&nbsp; </P> <P class=MsoNormal dir=rtl style="MARGIN-BOTTOM: -15px; DIRECTION: rtl; unicode-bidi: embed; mso-pagination: none; mso-layout-grid-align: none" align=center><A href="file://Nazi/e/sol-end/eng-tamas.htm">Contact Information</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/eng-maghale.htm"> Articles</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/news.htm"> Seientific meets &amp; events</A>&nbsp; |&nbsp;<A href="file://Nazi/e/sol-end/research.htm"> Research projects</A>&nbsp; |&nbsp; Theses</P></TD></TR></TBODY></TABLE></DIV></TD></TR></TBODY></TABLE></DIV></BODY></HTML>