CEREBROVASCULAR-DISEASE IN CHILDREN

Stroke although rare in children, is an important cause of morbidity i n the paediatric age group. Over a period of 8 years, 43 children (17 boys and 26 girls) in the age groups of 1-16 years (mean 8.02 yrs) pre sented with stroke which constituted 10% of all strokes in the young a nd 0.7% of all paediatric admissions. The chief clinical features were hemiplegia (86%), convulsions (27%), fever (23%), dysphasia (23%), he adache (11%) and altered level of consciousness (11%). Routine laborat ory tests were non-contributory. Cranial computerized tomography (CCT) on 21 patients was abnormal in 95% and was useful in revealing the ex tent of infarction. Infarction was confined to middle cerebral artery territory, often involving basal ganglionic structures and was associa ted with focal or diffuse atrophy. Angiograms were abnormal in 78% of the patients (18/23) and were complimentary to the CCT. Etiological fa ctors identified were: Moya-moya disease 6, arteritis 5, fibromuscular dysplasia 2, scorpion sting 2, and venous sinus thrombosis and small vessel occlusion one each. Though 23% of the patients had fever at ons et, no obvious evidence of systemic or CNS infection was noticed. Stro ke in children continues to pose a diagnostic challenge.