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Stroke in children in Yaounde, Cameroon
M T Obama1, L Dongmo, C Nkemayim
1University Teaching Hospital, Yaounde, Cameroon.
Insights
Pediatric stroke incidence is 1.85 per 1000 hospitalizations, with sickle cell disease and heart conditions as leading causes. Most children experience motor impairment and neurological deficits post-stroke.
Area of Science:
- Pediatric Neurology
- Epidemiology of Stroke
Background:
- Stroke in children is a significant neurological event with diverse etiologies.
- Understanding the incidence and risk factors for pediatric stroke is crucial for early diagnosis and management.
Purpose of the Study:
- To determine the incidence, etiological factors, and short-term outcomes of stroke in children.
- To identify common clinical features and diagnostic challenges in pediatric stroke cases.
Main Methods:
- A retrospective study of 35 pediatric stroke cases aged 5 months to 15 years.
- Data collected from August 1984 to July 1990 from two hospitals.
- Analysis of clinical features, etiological factors, and diagnostic investigations.
Main Results:
- Average annual incidence of 1.85 per 1000 pediatric hospitalizations.
- Common etiological factors included homozygous sickle cell disease (31.4%), heart disease (17.1%), cerebral malaria (14.3%), and meningitis (14.3%).
- Motor impairment (97.1%), facial paralysis (62.9%), and aphasia (28.6%) were the most frequent clinical signs. Computed tomography (CT) scans were valuable for diagnosis.
Conclusions:
- Pediatric stroke has a notable incidence, with significant contributions from hematological and cardiac conditions.
- Early diagnosis and intervention are vital, as most affected children experience neurological deficits.
- CT scans are essential for confirming ischemic stroke in pediatric populations.
Abstract:
Thirty five children aged 5 months to 15 years suffering from stroke were studied from August 1984 to July 1990 from two hospitals in order to determine the incidence, the etiological factors and the short term outcome of the stroke. The average annual incidence was 1.85 per 1000 pediatric hospitalizations. There was a progressive rise in the number of cases from 1985, with a peak in 1990. Motor impairment of one half of the body was the commonest clinical feature seen in 97.1% of the cases. Other clinical signs were: facial paralysis (62.9%) and aphasia (28.6%). The main etiological factors were: homozygous sickle cell disease (31.4%), heart disease (17.1%), cerebral malaria (14.3%) and meningitis (14.3%). No causative factor was identified in 7 patients (20%). The mortality rate was low (2.9%) and all the children had neurological deficit after a mean hospital stay of 15 days. Laboratory investigations including lipid analysis, platelet count, and skull X-rays proved to be of no diagnostic value. However, computed tomography (CT) scan confirmed the diagnosis of ischemic stroke whenever it could be done.