TY - JOUR
T1 - Diabetic ketoacidosis-associated stroke in children and youth
AU - Foster, Jennifer Ruth
AU - Morrison, Gavin
AU - Fraser, Douglas D.
PY - 2011
Y1 - 2011
N2 - Diabetic ketoacidosis (DKA) is a state of severe insulin deficiency, either absolute or relative, resulting in hyperglycemia and ketonemia. Although possibly underappreciated, up to 10 of cases of intracerebral complications associated with an episode of DKA, and/or its treatment, in children and youth are due to hemorrhage or ischemic brain infarction. Systemic inflammation is present in DKA, with resultant vascular endothelial perturbation that may result in coagulopathy and increased hemorrhagic risk. Thrombotic risk during DKA is elevated by abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. DKA-associated cerebral edema may also predispose to ischemic injury and hemorrhage, though cases of stroke without concomitant cerebral edema have been identified. We review the current literature regarding the pathogenesis of stroke during an episode of DKA in children and youth.
AB - Diabetic ketoacidosis (DKA) is a state of severe insulin deficiency, either absolute or relative, resulting in hyperglycemia and ketonemia. Although possibly underappreciated, up to 10 of cases of intracerebral complications associated with an episode of DKA, and/or its treatment, in children and youth are due to hemorrhage or ischemic brain infarction. Systemic inflammation is present in DKA, with resultant vascular endothelial perturbation that may result in coagulopathy and increased hemorrhagic risk. Thrombotic risk during DKA is elevated by abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. DKA-associated cerebral edema may also predispose to ischemic injury and hemorrhage, though cases of stroke without concomitant cerebral edema have been identified. We review the current literature regarding the pathogenesis of stroke during an episode of DKA in children and youth.
UR - http://www.scopus.com/inward/record.url?scp=79955056370&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79955056370&partnerID=8YFLogxK
U2 - 10.4061/2011/219706
DO - 10.4061/2011/219706
M3 - Review article
AN - SCOPUS:79955056370
SN - 2090-8105
JO - Stroke Research and Treatment
JF - Stroke Research and Treatment
M1 - 219706
ER -