Background and Purpose This report examines the occurrence of subcorti
cal infarction in 5 children, reviews the English literature, and disc
usses evaluation of this uncommon childhood illness. Methods Clinical
characteristics and neurological follow-up were examined in children w
ho presented with subcortical infarction within the past 7 years. The
English literature over the previous 20 years was reviewed to identify
similar patients with radiological documentation of subcortical infar
ction. Results Mean age of the patients in this series was 4.8 years (
range, 4 months to 12 years); 3 children were female. Three patients p
resented with the sudden onset of hemiparesis, 1 with dystonia, and 1
with fever and focal seizures. Protein C deficiencies were demonstrate
d in 2 children; a cardiomyopathy was seen in 1 patient. Mean follow-u
p was 1.5 years. Two patients were neurologically normal, mild residua
l symptoms persisted in 2, and 1 patient showed severe dystonia. The l
iterature analysis indicated that specific risk factors were described
in 79 patients; complete clinical analysis was available for 51 patie
nts. In the latter group, the mean age was 5.7 years; 26 children were
female. Forty-six presented with hemiplegia, 4 with dystonia, and 1 w
ith focal seizures. Follow-up greater than 5 months in 29 patients sho
wed complete or good resolution of deficits in 23. Specific risk facto
rs such as infection, trauma, hematologic disorders, or cardiac or vas
cular abnormalities were identified in 62 of 79 children. Conclusions
This analysis indicates that children with subcortical infarction usua
lly presented with acute hemiparesis. Risk factors were identified in
the majority of children, and follow-up demonstrated good or complete
resolution of neurological deficits in 80% of the patients.