Clinical Evaluation of Stroke in Infants and Children

ABSTRACT

PURPOSE: The causes of stroke in children are varied and morbidity by stroke is significant, it needs further investigations to identify the underlying causes. Despite significant morbidity in childhood, only a few studies have been reported. So we reviewed retrospectively clinical records, diagnosed stroke in neuroradiologic study and analyzed sex, age, cause, clinical features, mortality, lesion of brain injury and residual deficits. METHODS: From January 1994 to July 1997, 67 patients diagnosed with stroke in neuroradiologic study were studied retrospectively. We described age, sex distribution, underlying causes, clinical features, mortality, lesion of brain injury and residual deficits. RESULTS: There were 50 cases(74.6%) of ischemic stroke and 14 cases(20.9%) of hemorrhagic stroke. The most common cause was moyamoya disease in ischemic stroke and hemato- oncologic disease in hemorrhagic stroke. The presenting features were seizure, 30 cases(44.8%) ; motor deficit, 27 cases(40.3%) ; mental change, 15 cases(22.4%) ; and headache, 11 cases(16.4%). Forty-five cases(67.1%) involved carotid system and 13 cases(19.5%) involved vertebrobasilar system. The mortality rate was 19.4% and the rate of residual deficit was 63.0%. CONCLUSION: Cerebrovascular disease in childhood is not an uncommon occurrence in Korea considering these results. As a consequence of medical progress, early mortality rate has decreased, but the rate of residual deficits tended to increase. So further studies on childhood stroke are required for early diagnosis and treatment which are important in decreasing mortality and morbidity.