Clinical and Radiological profile of stroke in children

AUTHOR(s) : Das Marami1 , Santosh H2 , Basumatary Lakshya J3 , Goswami Munindra4 , Bezboruah Gayatri5 , Kayal AK6
DOI No. : 10.31741/ijhrmlp.v4.i2.2018.4

ABSTRACT :
Stroke in children although relatively rare, needs to be addressed separately as it frequently results in a lack of recognition and a delay in its diagnosis. The various fundamental developmental differences, varied etiological factors and multiple risk factors co-existing make the recognition and treatment of stroke in children different when compared with adults. Method: A prospective analysis of 82 cases of stroke in children aged between 1 month to 18 years was undertaken. Stroke was categorized into ischemic (arterial or venous) and intracerebral hemorrhage (ICH). Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria and ICH location was used to classify and stroke severity was assessed using the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) and ICH score respectively. Neuroimaging (CT/ MRI) was done in all cases and were analyzed. Results: Hemiparesis was seen in 69 (84.2%), speech disturbance in 31 (37.8%), ataxia in 5 (6.1%) and seizures in 29 (35.4%) cases. Anterior circulation territory was involved in 60 (84.5%), the posterior circulation territory in 7 (9.9%), and both in 4 (5.6%) cases. Infections were the most common cause of stroke noted in 43 (60.6%) cases. Conclusion: Intracranial infection is the commonest etiology of stroke in children below 18years presenting to our hospital. Commonest type of stroke is an ischemic stroke. Most patients improve with conservative management and there is a high survival rate in childhood stroke if timely managed.

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