Clinical presentation and etiology of stroke in children

Farrah Naz, Afsheen Batool Raza, Muhammad Yaqoob Kazi, Tahseen Fatima

Research output: Contribution to journalArticlepeer-review


Aim and objective: To determine the variable clinical presentations and etiology of stroke in children. Patients and methods: It was a descriptive, observational study conducted in department of pediatric medicine and neurology of The Children’s Hospital and the Institute of Child Health Lahore, from October 2009 to April 2011. A total of 70 patients between 2 months to 16 years of age with a diagnosis of acute stroke were included in the study. Patients with Guillain Barre syndrome, spinal trauma, any weakness due to birth asphyxia and poliomyelitis were not included in this study. All the data were entered in SPSS-version 16 and results were analyzed. Results: Over eighteen months study period, 75 patients were enrolled. Five patients were later excluded. Amongst 70 patients, 40 (57%) were male and 30 (43%) female. As far as age is concerned, 7 (10.2%) were less than 1 year, 47 (67%) between 1- 5 years and 16 (22.8%) patients were more than 5 years. The mean age was 3.5 years. There were 50 ischemic strokes (71.5%), 12 cases of hemorrhagic (14.3%), and 8 cases of combined (ischemic and hemorrhagic) stroke (11.4%). Regarding neurological findings, 47 patients (67.14%) presented with hemiplegia, right sided involvement in 33 (47.1%) and left sided in 14 (20%) cases. Nineteen patients (27.1%) had monoplegia, 17 (24.28%) with an upper limb weakness and 2 (2.85%) presented with lower limb weakness. Headache in 40 (57%), seizures in 28 (40%) and fever in 27 (38.4%) were the common presenting symptoms. Twenty patients (28.73%) presented with decreased conscious level while 9 (12.8%) had involvement of 7th cranial nerve. Median time taken from onset of symptoms to presentation in tertiary care was 15 days + 23.1. As far as localization of infarction in brain, is concerned there were left sided cerebral infarcts in 33 (47.1%) and right sided in 14 (20%) cases. Remaining 23% cases had no evidence of infarction. Idiopathic cases were 28 (40%). Amongst identifiable causes, intracranial infections 27 (38.5%) were the commonest cause of stroke in children. Overall mortality was 10% (7 cases) while survival was seen in 63 cases (90%). Conclusion: The most common presentations of stroke in our study were hemiplegia/ hemiparesis, headache, seizures and fever. Amongst the identifiable etiology, intracranial infections were common. Early recognition is only possible by keeping high index of suspicion, so that prompt treatment can be ensured which can prevent morbidity.

Original languageEnglish
Pages (from-to)104-108
Number of pages5
JournalPakistan Paediatric Journal
Issue number2
Publication statusPublished - Jun 2017
Externally publishedYes


  • Arterial ischemic stroke (AIS)
  • Cerebrovascular accident (CVA)
  • hemiplegia
  • monoplegia


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