Aetiology and risk factor assessment in children with stroke presented to Stroke Unit, National Hospital of Sri Lanka

Abstract

Objective: Evaluation of aetiology and risk factors in children with stroke in Sri Lanka.

Introduction: Aetiology and risk factors for stroke in children may vary between different communities and geographical locations. The risk factors for stroke in children are numerous and differ greatly from adults; a thorough diagnostic evaluation can identify aetiology/risk factors in most patients. Aetiologies/risk factors for stroke in children in Sri Lanka are not known to date.

Method: The data of children aged 1 to 16 with stroke presented to stroke unit from January 2005 to June 2007 were analyzed.

Results: There were 30 patients with an age range of 1-16years (mean age 8.5 years). Boys 53%. There were 25 (83%) ischaemic and 5 (17%) intracerebral haemorrhages. Possible aetiology was determined in 25(83%). Of those with intracranial haemorrhages, two presented with AVMs and one each with haemophilia, low platelets and trauma. Commonest cause for stroke was cardioembolic (20%), followed by unknown causes (17%). Extra cranial carotid dissections, infective/inflammatory causes and Moya moya disease accounted for 7% each. One child had a stroke following snake bite.

Conclusion: Ischemic stroke is the commonest cause for paediatric stroke in the present series, an aetiology for ischemia was detected in 83%. Cardioembolic was the commonest cause identified. In 17% of patients no cause was identified despite extensive investigations. Investigating a larger group would gather more information for Sri Lanka.