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

Author: Nebal Waill Saadi Al-Dabbas*, Batool Ali Ghalib Yassin**, Ahmed Mahdi Ibrahim***, Waleed Khalid Abbas Ageedi****
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 194-201
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

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. .


Article
Clinico-epidemiological study of childhood stroke in Children Welfare Teaching Hospital/Baghdad

Authors: Husham Z.Hammoodi هشام زهير حمودي --- Lamyaa A.Hammoodi لمياء عبد الكريم حمودي --- Akram M. Al-Mahdawi اكرم المهداوي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2017 Volume: 59 Issue: 1 Pages: 42-46
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The annual incidence of stroke in children after the newborn period is approximately 2.3 per 100000. Half are ischemic, and half are non-traumaticintracerebral and subarchnoidal hemorrhages.Objectives: To study the etiologic factors, clinical presentation andoutcome of stroke among children admitted to children welfare teaching hospital/Baghdad.Patient and methods: A prospective study was carried out in Children Welfare Teaching Hospital;Children age ranged between 1 month -13 years and was admitted to pediatric neurology ward between 1st of November 2013 and 1st of November 2014. After carful clinical history, physical and neurological examinations, the diagnosis of brain stroke was confirmed in all patients by computerized tomography (CT) and/or magnetic resonance imaging (MRI). Patients included in this study were those diagnosed as having ischemic stroke, hemorrhagic stroke.Results: The total number of cases were 61, 36 were male (59%). The age at onset ranged from 1-156 months. Ischemic stroke constituted 39 patients (63.9%). The most common etiologic factors for the ischemic stroke were protein C deficiency (9, 23.1%). The most common etiologic factor for hemorrhage was bleeding disorders in about 50% of patients. The most common presenting features were hemiplegia, seizure, alteration of consciousness; Cranial nerves palsy is mostly present in the ischemic stroke (14,35.9%) and only in one patient (4.5%) of hemorrhagic stroke.Conclusions: Ischemic stroke is more common than hemorrhagic stroke in pediatric age group. The significant risk factors for ischemic stroke are protein C deficiency, Congenital heart disease(CHD) and positive family history, while vitamin K deficiency, prolong Partial thromboplastin time (PTT) and trauma are significant for hemorrhagic stroke. The most common clinical features of both types of stroke are hemiparesis, siezure and alteration of consciousness.Keywords:Ischemic stroke, Hemorrhagic stroke, Children Welfare Teaching Hospital.

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