Evaluation of Cerebrovascular Events Followed in Pediatric Intensive Care Unit.

Abstract

Stroke is defined as an acute neurological deficit caused by cerebrovascular events (CVEs). In this study, we evaluated the effect of intensive care follow-up and treatment methods on the prognosis of 28 patients admitted to the pediatric intensive care unit (PICU) due to stroke. The data of patients aged between 28 days and 18 years followed up between 2011 and 2021 were recorded retrospectively. Thirteen (48.1%) patients were diagnosed with hemorrhagic stroke (HS), 11 (40.7%) patients were diagnosed with acute ischemic stroke (AIS), and three (11.1%) patients were diagnosed with cerebral sinus vein thrombosis. One patient was followed up for non-ruptured arteriovenous malformation (AVM) and was excluded from the HS group. The HS group consisted of eight patients with ruptured AVMs and five patients with ruptured intracranial aneurysms. The patients had male predominance, and seizures and headache were the most common complaints on admission. The rate of admissions due to seizures was higher in the AIS group. In the HS group, there was more involvement of the right side of the brain. Middle cerebral artery (MCA) involvement was higher in the AIS group. The AIS group had longer PICU hospitalization days and mechanical ventilator days. While unfractionated heparin was preferred for the treatment in the AIS group, endovascular embolization was preferred in the HS group. Decompressive surgery was performed in five patients. The overall mortality rate was 7.1%. Although CVEs are rare in the pediatric population, achieving low mortality and morbidity is possible with the correct diagnostic and treatment methods.