Pediatric Stroke in Southern Iran; Clinical Presentations, Etiologies and Outcomes: A Case-Series and Review of Literature

Background:  Pediatric stroke is defined as rapid developing clinical signs of focal (or global) disturbance of cerebral function without any apparent cause other than of vascular origin lasting for ۲۴ hours or longer in the ages of ۱ month to ۱۸ years.  It is relatively rare in children, however, it can lead to significant mortality and morbidity. Objectives:  The present study aimed to identify clinical presentations, etiologies, and outcomes of pediatric stroke in southern Iran. Methods:  This case-series study included all patients that were diagnosed with a pediatric stroke and admitted to the Pediatric Neurology ward at Namazi hospital in Shiraz, Iran, from May ۲۰۰۹ through March ۲۰۱۲. Results:  During the study period, ۴۰ newly diagnosed patients (۲۷ males and ۱۳ females) between the ages of ۱۰ months and ۱۸ years old were identified. The most prevalent referring symptoms were hemiparesis and hemiplagia (۶۵%), seizures (۴۵%), speech difficulties (۴۲.۵%), and altered mental status (۳۵%). A known single etiology was identified in ۸۲.۵% of patients. The most common single risk factor was cardiac abnormalities with ۳۰% frequency, followed by idiopathic and vascular with ۱۷.۵%. The outcome of pediatric patients revealed incomplete recovery with moderate neurological deficits (۴۵%) including residual epilepsy (۱۵%), speech difficulties (۱۵%), and behavioral dysfunction (۷%), which indicate their need for help in some of their daily activities. Conclusions: Stroke in southern Iranian pediatric patients demonstrated different patterns of causes and risk factors with similar clinical presentations and outcomes.

Keywords:

Stroke , Risk Factor , Children , Adults , Iran