Acute Cerebrovascular Diseases in Children: Single Center Experience

Abstract Background In children, cerebrovascular events are classified into acute ischemic or hemorrhagic stroke. Ischemic stroke includes both arterial ischemic stroke (AIS) and cerebral sino-venous thrombosis (CSVT). Compared to adults, pediatric cerebrovascular events have a heterogeneous etiology and various clinical presentations. Both factors lead to a delay in diagnosis and proper management. Aim Our aim is to study risk factors for the occurrence of cerebrovascular events in children. Patients and Methods A retrospective medical record review for all children admitted to Children's Hospital, Ain Shams University from 2010-2021. All records with radiological diagnosis of a cerebrovascular event AIS, CSVT or Hemorrhagic stroke were included. Full history, family history of stroke, known risk factor of stroke like (genetic factors, cardiac, hematological, thrombophilia, collagen diseases…etc), precipitating factors for stroke before the onset or conditions like (acute illness, dehydration, head or neck trauma…etc) were reviewed. Records of full detailed neurological examination and full general and systemic examination at ER arrival were all included. Results sixty- two children were diagnosed as acute cerebrovascular events, 42 (71%) as AIS, 13(21%) CVST, and 7(11.3%) Hemorrhagic Stroke (HS). The age at diagnosis was 74.2% (2-6 years), 11.3% (6-10 years), 11.3% (10-14 years), and 3.2% (14-18 years). Acute illness preceded acute stroke in (31) 50%, dehydration in (2) 3.2%, head or neck trauma in (3) 4.8%, cardiac catheterization in (7) 11.3%, and chemotherapy in (1) 1.6%. There were no stroke risk factors in (30) 48.4%, cardiac (8)12.9%, hematological (2) 3.2%, thrombophilia (5) 8.1%, genetic (7) 11.3%, infection (3) 4.8%, collagen or vascular diseases (4) 6.5%, family history (2) 3.2%, and cardiac and genetic (1) 1.6%. Conclusion While there were not risk factors in half of the admitted children for acute stroke, acute illness was the commonest precipitating factor for acute stroke. The most common risk factor was cardiac diseases and cardiac catheterization.