Monday, April 14, 2008

Search challenge 6

This week's search challenge is another question that takes a look at the pediatric literature: What are the causes of pediatric ischemic stroke?

A few related issues to consider:
- how important are case reports for this question?
- is there a reference text or other resource that is useful, in addition to Medline?
- how broad does a Medline search need to be to retrieve most of the "good" items for this question?



Blogger Becky said...

Martin from Germany suggests:

"Brain Infarction"[Mesh] AND (cause OR etiology)
Limits: Review, English, Preschool Child: 2-5 years, Child: 6-12 years, Adolescent: 13-18 years

I get 77 hits (I originally included consesensus conference, meta-analysis and editorial) and found the following relevant articles:

1: Trescher WH.
Ischemic stroke syndromes in childhood.
Pediatr Ann. 1992 Jun;21(6):374-83. Review.
PMID: 1620562 [PubMed - indexed for MEDLINE]

2: Hilton-Jones D, Warlow CP.
The causes of stroke in the young.
J Neurol. 1985;232(3):137-43.
PMID: 4031955 [PubMed - indexed for MEDLINE]

3: Martin PJ, Enevoldson TP, Humphrey PR.
Causes of ischaemic stroke in the young.
Postgrad Med J. 1997 Jan;73(855):8-16. Review.
PMID: 9039403 [PubMed - indexed for MEDLINE]

4: Toffol GJ, Swiontoniowski M.
Stroke in young adults. A continuing diagnostic challenge.
Postgrad Med. 1992 Mar;91(4):123-8. Review.
PMID: 1546006 [PubMed - indexed for MEDLINE]

Looking at the 5 related articles for each hit I found the following studies:

1: Wang LH, Young C, Lin HC, Wang PJ, Lee WT, Shen YZ.

Strokes in children: a medical center-based study.

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1998 Jul-Aug;39(4):242-6.

PMID: 9775494 [PubMed - indexed for MEDLINE]

2: Gautier JC, Pradat-Diehl P, Loron P, Lechat P, Lascault G, Juillard JB,

Grosgogeat Y.

[Cerebral vascular accidents in young subjects. A study of 133 patients 9 to 45

years of age]

Rev Neurol (Paris). 1989;145(6-7):437-42. French.

PMID: 2799209 [PubMed - indexed for MEDLINE]

3: Klein GM, Seland TP.

Occlusive cerebrovascular disease in young adults.

Can J Neurol Sci. 1984 May;11(2):302-4.

PMID: 6733611 [PubMed - indexed for MEDLINE]

4: Bevan H, Sharma K, Bradley W.

Stroke in young adults.

Stroke. 1990 Mar;21(3):382-6.

PMID: 2309261 [PubMed - indexed for MEDLINE]

5: Biller J, Adams HP Jr.

Diagnosis of stroke in young adults.

Postgrad Med. 1987 Apr;81(5):141-4, 149-51.

PMID: 3562368 [PubMed - indexed for MEDLINE]

You suggested looking at case reports, but that yields too many hits, mostly about bizarre causes.
I went toTRIP and found a guidline that gave a relevant tip: Kirkham FJ (1999) Stroke in childhood. Archives of Disease in Childhood 81: 85–89.
Besides, TRIP was not too helpfull in solving the question with little time.

I got some additional relevant hit with this strategy: stroke[ti] AND child*[ti] AND (cause[ti] OR etiology[ti] OR aetiology[ti])

1: Daseking M, Heubrock D, Hetzel A, Petermann F.
[Stroke in children and adolescents. Epidemiology--etiology--neurological
deficits--neuropsychological manifestations]
Nervenarzt. 2003 Dec;74(12):1088-97. Review. German.
PMID: 14647909 [PubMed - indexed for MEDLINE]

2: Roach ES.
Etiology of stroke in children.
Semin Pediatr Neurol. 2000 Dec;7(4):244-60. Review.
PMID: 11205715 [PubMed - indexed for MEDLINE]

3: Kotlarek F, Thron A, Weber U, Schneider R.
[Stroke in the child: etiology, differential diagnosis, relevant diagnostic
procedures and therapeutic possibilities]
Klin Padiatr. 1993 Sep-Oct;205(5):332-9. Review. German.
PMID: 8411898 [PubMed - indexed for MEDLINE]

4: Riela AR, Roach ES.
Etiology of stroke in children.
J Child Neurol. 1993 Jul;8(3):201-20. Review.
PMID: 8409261 [PubMed - indexed for MEDLINE]

Acutally, 2 of them are german (which the majority of your readers cannot understand).

So, that's my input to the challenge. I did not strive for completeness but for a small time frame.

4/17/2008 7:21 AM  

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