Acute arterial ischemic stroke in children: single-center experience

Background Arterial ischemic stroke (AIS) is an increasingly common disorder in childhood that causes severe mortality and morbidity.Objective To emphasize the importance of early diagnosis and treatment of AIS cases, as well as the early initiation of physical therapy. Methods We retrospectively reviewed the medical records of 23 patients aged 1 month to 18 years, who were admitted with acute neurological complaints and diagnosed radiologically with AIS at the Bursa Y & uuml;ksek & Idot;htisas Training and Research Hospital, a tertiary healthcare facility, between January 2016 and June 2020. Results Neurological deficit was the most common (12 patients; 52%) complaint, followed by seizure in 5 patients (21%), facial paralysis in 5 patients (21%), and visual impairment in 3 patients (13%). We performed brain computed tomography (CT) scans in 12 (52%) patients at the first application, and infarction was detected in 8 (66%). Infarction was in the cerebrum in 19 (82%) patients. Mutations of the methylenetetrahydrofolate reductase ( MTHFR ; A1298C and 677C > T) gene were found most frequently. Cardiac anomalies were detected in 7 (30%) patients, and 2 patients had ventriculoperitoneal shunts. Conclusion Arterial ischemic stroke presents very different clinical findings, such as hiccups, anisocoria, and upward gaze paralysis. We wanted to emphasize the importance of cranial CT scanning because sometimes MRI is not always easily performed in children. Concomitant conditions, such as intracranial operation, ventriculoperitoneal shunt, and hypochondroplasia, may increase the risk of stroke.