Management and Outcome of Stroke in a Sample of Children Admitted to Children Welfare Teaching Hospital/Baghdad


ABSTRACT:BACKGROUND: Stroke in children is a serious disorder in which little has been published. Population-based estimates of the annual incidence of childhood stroke (ischemic and haemorrhagic) range from 2•3 to 13•0 per 100 000 children and incidence rates in neonates are closer to 1 per 5000 live births CONCLUSION:To determine clinical presentation, etiologies, diagnostic procedures, treatment options and outcome of children with stroke.METHODS: Descriptive study of patients with stroke admitted to Children Welfare Teaching Hospital/Baghdad from October 2011 to September 2012 was conducted. Cases were classified radiologically into ischemic stroke (IS) and hemorrhagic stroke (HS) and their management modalities were studied.RESULTS: Out of 21 patients; 13 (61.9%) had hemorrhagic and 8 (38.1%) had ischemic stroke. Female:male ratio was 1.3:1. Haemorrhagic stroke was more among males and infants; ischemic stroke was more among females and older children. In 16 (76%) patients, the diagnosis was established after more than 24 hours of onset. Patients with ischemic stroke spend longer time in hospital. Seizure was the commonest clinical feature in both types (17 patients (81%)) followed by altered mental status (16 patients (76.2%)). CT-scan was abnormal in 20 patients and MRI in 11 patients. Complete recovery was noticed in 7 (54%) patients with hemorrhagic type, while 7 (87.5%) patients with ischemic type recovered with sequelae.CONCLUSION: Stroke was more common among female and children younger than 12 months. Seizure and altered mental status were the commonest presentations. A delay in performing neuroimaging was obvious in the current study. Patients with ischemic stroke tend to spend longer time in hospital. Antibiotic were the medication most often used. The majority of children were discharged well. .