A Case Series of Non-Traumatic Pediatric Intracerebral Hemorrhage Hospitalized in Picu within a 10-Year Period

ABSTRACT

BACKGROUND AND AIM: Intracerebral hemorrhage (ICH) accounts for about half of all childhood strokes and is a notable contributor to childhood morbidity and mortality. The aim of this study is to describe the characteristics of cases of ICH that were hospitalized in a PICU during a 10-year period. METHOD(S) Patients' files between 2011-2021 were studied retrospectively. Cases with non-traumatic intracerebral hemorrhage were included in the study. RESULT(S) 18 patients were examined (38.8% male) with a median age of 7 years (3 months-14 years). 83% were of Greek origin and mean duration was 6.3 days. Half of our patients were hospitalized between 2020-2021 (see image 1.). 33.3% had relevant comorbidities such as arteriovenous malformation (AVM), hemangiomas and neurofibromatosis type. Presenting symptoms were headache (55.5%), nausea and emesis (66.6%), seizures (27.7%), altered level of consciousness (65.5%), paresis (22%). Glasgow Coma Scale at admission was 13-15 in 66.6%, 9-12 in 22.2% and < 9 in 5%. Diagnosis was made using CT (88,9%) and MRI scans (11.1%). 61% needed surgery while 72% underwent digital subtraction angiography (DSA) and 38.4% of them were embolized. Vascular malformations were the main causes AVM (38.8%), aneurysm (5%), pseudoaneurysm (5%), hemangioma (5%) but 46,2% remained unidentified. No patient died but 33.3% showed neurological deficits after discharge CONCLUSION(S) Intracerebral Hemorrhage in children is an urgent situation that needs collaboration between intensivists and neurosurgeons. The increase in frequency during COVID-19 pandemic is remarkable and needs further studying to determine a possible causative relation.