Childhood stroke in Eastern Province, KSA: pattern, risk factors, diagnosis and outcome.
OBJECTIVE
Stroke has been increasingly recognized in children in recent years, but diagnosis and management can be difficult because of the diversity of underlying risk factors, atypical presentation and the absence of a uniform treatment approach. The aim of this study was to examine risk factors, clinical presentation, imaging findings and outcomes of paediatric stroke in Eastern Province, Kingdom of Saudi Arabia (KSA).


METHODS
We evaluated 25 patients (11 boys and 14 girls) using computerized tomography scan of the brain, magnetic resonance (MR) imaging and MR angiography. Cardiac assessment, haematological tests, immunological tests, infection and metabolic screening were also performed in the patients. After discharge, the patients were monitored regularly in the neurology clinic to detect their outcomes.


RESULTS
A total of 76% of the patients presented with ischaemic stroke, while the remaining 24% had haemorrhagic stroke. Sickle cell disease (SCD) was the commonest risk factor for stroke (36%) followed by non determinate causes (20%). Seizure was the commonest clinical presentation (54%) followed by haemiplegia (31%) and decreased level of consciousness (30%). Recurrence occurred in SCD patients (80%) and patients with moyamoya disease (20%). Regarding the outcome, long-term deficit was the commonest (44%), while short-term deficit and death were equal (28% each).


CONCLUSIONS
Our study in Eastern Province, KSA, showed agreement with other studies regarding risk factors, clinical presentation, imaging features and outcomes of stroke in children, yet with some points of differences, which are as follows: (1) SCD is the commonest risk factor in our study population, while in Chinese study it was not, (2) The percentage of cardiac disorders as a risk factor in this study was less than that in the European and American studies, and (3) there was relative discrepancy regarding predictors of outcome.
Emam
Abdelhady Taha
AT
Department of Radiology, Cairo University, Egypt. abdelhadytaha@hotmail.com
Ali
Alsayed Mohammed
AM
Babikr
Malek Ahmed
MA
D000755:Anemia, Sickle Cell / Q000150:complications*; D002545:Brain Ischemia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012640:Seizures / Q000209:etiology; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D014057:Tomography, X-Ray Computed