Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 30 , ISSUE 3 ( July-September, 2019 ) > List of Articles

Original Article

Pediatric Stroke: The Clinical and Etiological Spectrum: An Observational Study from a Tertiary Care Stroke Clinic, Kolkata, India

Souvik Dubey, Ritwik Ghosh, Subhankar Chatterjee, Durjoy Lahiri, Samya Sengupta, Subham Chatterjee, Goutam Das, Samar Biswas, Biman K Ray

Keywords : Infections, Outcome, Pediatric stroke outcome measure, Vasculopathy,Hemiplegia

Citation Information : Dubey S, Ghosh R, Chatterjee S, Lahiri D, Sengupta S, Chatterjee S, Das G, Biswas S, Ray BK. Pediatric Stroke: The Clinical and Etiological Spectrum: An Observational Study from a Tertiary Care Stroke Clinic, Kolkata, India. Indian J Phy Med Rehab 2019; 30 (3):74-80.

DOI: 10.5005/jp-journals-10066-0058

License: CC BY-NC 4.0

Published Online: 22-10-2020

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: In different geographical regions, the clincoetiological spectrum of childhood stroke varies widely and studies from Eastern India is lacking. Objective: To determine the clinicoetiological spectrum of childhood stroke and their outcome. Materials and methods: This study was conducted in a stroke clinic of a tertiary care hospital of Kolkata over a period of 18 months. All children below 12 years diagnosed as stroke were included. On the basis of clinical examination, relevant laboratory investigations and radioimaging etiologies were determined. Appropriate statistical methods were used to analyze the data gathered from these patients using a preformed proforma. Results: Among the 70 pediatric stroke patients, the most common clinical presentation was found to be hemiparesis (61.42%) followed by seizure (30.00%) and aphasia (25.71%), respectively. Vasculopathies (30.00%) were found to be the most common etiology of childhood stroke followed by infective meningoencephalitis and craniocervical trauma (14.28% each). Ischemic stroke comprised 71.4% of cases. During discharge, 20 cases (28.57%) showed complete recovery, whereas 40 cases (57.14%) had persistent neurodeficit [Pediatric Stroke Outcome Measure (PSOM) score >1], 12 cases (17.14%) had recurrent stroke, 8 cases (11.42%) died, and only 2 (2.85%) patients were lost to follow-up. Out of those 40 cases having persistent neurodeficits during discharge had recovered too at follow-up at 18th month. At presentation PSOM score in 40 cases (57.14%) was >5 and at follow-up at 18th month, only 8 cases (11.42%) had PSOM score of >5. Conclusion: The commonest etiologies of stroke in pediatric patients presenting at our hospital were found to be intracranial vasculopathies, infection, and trauma. Ischemic stroke was the predominant type. Eighteen-month follow-up showed complete recovery from acute neurological deficits in most of the patients.


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