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[Ischemic stroke in children]
J Benito-León1, A L Guerrero, R Simón
1Servicio de Neurología Infantil, Hospital Universitario 12 de Octubre, Madrid, España. jbenitol@meditex.es
Insights
Pediatric ischemic stroke is rare, with varied causes including idiopathic, heart disease, and migraine. Many children experience long-term disabilities like hemiparesis and epilepsy after this condition.
Area of Science:
- Neurology
- Pediatrics
- Vascular Medicine
Context:
- Ischemic stroke in pediatric populations is an uncommon yet significant neurological event.
- Understanding the diverse etiologies and outcomes is crucial for effective management.
Purpose:
- To analyze the clinical characteristics, etiological factors, and outcomes of ischemic stroke in a cohort of 23 pediatric patients.
- To identify common and unusual causes, as well as the sequelae of pediatric ischemic stroke.
Summary:
- This retrospective study reviewed 23 pediatric patients (1 month to 13 years) with ischemic stroke.
- Common etiologies included idiopathic (30.4%), cardiopathy (21.7%), and migraine (17.4%). Vertebro-basilar territory strokes occurred in 21.7% of cases.
- Outcomes varied, with 39.1% achieving complete recovery, 4.3% mortality, and 56.6% experiencing disabilities such as hemiparesis and epilepsy.
Impact:
- Highlights the multifactorial nature of pediatric ischemic stroke, emphasizing the need for comprehensive etiological investigation.
- Underscores the significant long-term morbidity associated with pediatric ischemic stroke, impacting quality of life.
- Identifies unusual etiologies like migraine and Mycoplasma pneumoniae infection, broadening the differential diagnosis for pediatric stroke.
Objective:
Ischemic stroke in children and infants is a rare condition. We present a series of 23 pediatric patients of ischemic stroke.
Patients And Methods:
A retrospective series of 23 patients, aged between 1 month and 13 years, diagnosed by anamnesis, clinical examination and neuroimaging. The clinical picture, neuroimaging findings, etiology, evolution and sequelae are evaluated.
Results:
Eighteen of the patients had an ischemic stroke in the carotid territory (78.3%) and 5 in the vertebro-basilar (21.7%). Idiopathic (30.4%), cardiopathy (21.7%) and migraine (17.4%) were the most frequent etiologies. The recovery was complete in 9 patients (39.1%). There was a death as a result of systemic complications caused by dehydration (4.3%), and 13 patients (56.6%) were disabled: 6 with hemiparesis of diverse grades, 5 with epilepsy and hemiparesis, one with epilepsy, and one with mental retardation.
Conclusions:
Ischemic stroke in children and infants is an unusual entity. The causes are multiple, although there is an elevated percentage of idiopathic cases. In our series, we highlight the significative percentage of vertebro-basilar strokes and the finding of three unusual etiologies in ischemic stroke in childhood, such as migraine, Mycoplasma pneumoniae infection and smallpox.