Ischemic Stroke in Children a Case Report

Ischemic stroke in children is a rare yet serious condition with high risk of morbidity and long-term neurological sequelae. Early diagnosis and management are often challenging due to subtle clinical presentations and the wide differential diagnoses in pediatric patients. We report a case of a 2-year-old girl who presented with persistent left-sided hemiparesis first noticed at the age of 9 months. MRI revealed chronic infarction in the right corona radiata and lentiform nucleus. Magnetic resonance venography (MRV) suggested left transverse sinus thrombosis. There was no evidence of cardiac abnormalities, thrombophilia, or infection. The patient was diagnosed with chronic ischemic stroke and underwent regular physiotherapy. One year later, she developed generalized tonic-clonic seizures. EEG findings supported the diagnosis of epilepsy with structural etiology. Laboratory investigations revealed vitamin D insufficiency, which may have contributed to post-stroke epilepsy. This case underscores the complexity of diagnosing pediatric stroke, particularly when presentation is delayed. Arteriopathy and cerebral venous sinus thrombosis were the most likely causes. Risk factors for post-stroke epilepsy in this case include neurological deficits, cortical involvement, and low vitamin D levels. Early neuroimaging, appropriate rehabilitation, and long-term monitoring are essential in optimizing neurological outcomes. Pediatric stroke, though uncommon, can lead to significant disability if not identified and managed early. This case illustrates the importance of timely neuroimaging and long-term follow-up, especially in children under one year of age who are at increased risk of poor outcomes and epilepsy.