Ischemic stroke in pediatric age

Objective. Ischemic stroke in children and infants is a rare condition. We present a series of 23 pediatric patients of ischemic stroke. Patients and methods. A retrospective series of 23 patients, aged between I month and 13 years, diagnosed by anamnesis, clinical examination and neuroimaging. The clinical picture, neuroimaging findings, etiology, evolution and sequelae are evaluated. Results. Eighteen of the patients had an ischemic stroke ill the carotid territory (78.3%) and 5 in the vertebro-basilar (21.7%). Idiopatic (30.4%), cardiopathy (21.7%) and migraine (17.4%) were the most frequent etiologies. The recovery was complete in 9 patients (39.1%). There was a death as a result of systemic complications caused by dehydration (4.3%), and 13 patients (56.6%) were disabled: 6 with hemiparesis of diverse grades 5 with epilepsy and hemiparesis, one with epilepsy, and one with mental retardation. Conclusions. Ischemic stroke in children and infants is an unusual entity. The causes are multiple, although there is an elevated percentage of idiopatic cases. In our series, we highlight the significative percentage of vertebro-basilar strokes and the finding of three unusual etiologies in ischemic stroke in childhood such as migraine, Mycoplasma pnemoniae infection and smallpox.