Experience of pediatric stroke from a tertiary medical center in North India

Abstract

Objective: The etiology and outcome of pediatric stroke differs in different geographical regions and there is no comprehensive study from India. This study evaluates the etiology, type and predictors of outcome of pediatric stroke from Northern India.

Methods: 79 stroke patients aged 1month to 18years managed during 2001-2011 were retrospectively analyzed. Their mean age was 144.8months (0.6-18years) and 26 were females. Detailed history including stroke risk factors was noted. The clinical, imaging and laboratory findings were recorded. Stroke was classified as per neuroimaging findings. The predictors of death were evaluated by multivariate analysis.

Results: 62 (78.5%) patients had arterial ischemic stroke (AIS), 10 (12.7%) intracerebral hemorrhage (ICH) and 7 (8.9%) had cerebral venous sinus thrombosis (CVST). The underlying etiology was neuroinfections in 25, cardioembolic in 9, prothrombotic conditions in 5, arteriopathy in 4, arterial dissection in 3, mitochondrial cytopathy and cervical rib in 1 each and cryptogenic in 13 patients. 7 patients died. On multivariate analysis death was related to level of consciousness on admission.

Conclusion: AIS is more common than ICH in this study and 8.9% patients died. Infection is the most common cause of pediatric stroke in Northern India which is amenable to therapy and is preventable.