Abstract
Background
Although stroke among children is rare, it can cause significant morbidity and mortality.
We aim to share our experience of children with arterial ischemic stroke.
Methods
The initial symptoms, demographical features, risk factors, neurological examination,
neuroradiological findings, and clinical follow-up data of 130 Turkish children seen
between 2002 and 2013 were retrospectively analyzed.
Results
Sixty-eight patients were male. Thirty of the children were aged from 1 to 12 months
(seven of them died in this period). Focal neurological signs were the most common
presentation, and hemiplegia or hemiparesis were the most common focal signs. Underlying
risk factors were detected in 103 patients. Infections and congenital heart disease
were the most common risk factors. Seven of the nine children with recurrent arterial
ischemic strokes had one or more underlying diseases (moyamoya disease in two children
along with factor V Leiden mutation, tuberculous meningitis, congenital heart disease,
homocystinuria, and hemiconvulsion-hemiplegia-epilepsy syndrome). The arterial ischemic
stroke was located in the middle cerebral circulation in 68 (36 left and 32 right)
and in the posterior cerebral artery in 41. Eighteen children died. The neurological
outcome was assessed in 98 children. Of these children, 66 children have neurological
deficits and 52 children have seizures. Stroke in the first year of life is more often
fatal. Recurrent stroke is associated with poor prognosis.
Conclusion
Tuberculous meningitis is still a risk factor for arterial ischemic stroke in Turkey.
Arterial ischemic stroke in the first year of life and recurrent arterial ischemic
stroke represent poor prognostic features.
Keywords
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Article info
Publication history
Published online: January 27, 2014
Accepted:
December 7,
2013
Received:
August 24,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
