Stroke in childhood

Abstract

Stroke in childhood is one of the most common causes of death or severe impairment worldwide, with annual incidence estimated from 1,3 to 13 cases/100.000 population. The definition of stroke consists both of arterial ischemic stroke (AIS) and hemorrhagic stroke. The incidence of ischemic and hemorrhagic stroke in children is approximately the same, in contrast to adults, while the incidence is higher in boys than it is in girls. Risks factors for pediatric stroke differ from those for adults, with arteriopathy and infections being the most commonly risk factors, followed by cardiac diseases. Clinical presentation of stroke in childhood depends on the affected area of the brain, with focal neurological deficit being the most common presentation in older children. The existence of stroke mimics and lack of typical findings in early neuroimaging lead to delay in diagnosis and poor prognosis. The adequate therapy has improved the outcome from pediatric stroke. However, this must be instituted within 3 to 6 hours. Prognosis of pediatric stroke is generally poor, depending on underlying condition. 10% of children who have stroke die, 20% have recurrent stroke and 70% have severe deficits. Our goal should be the rapid diagnosis and therapeutic management, which can contribute to improved outcomes in pediatric stroke.