Causes and Types of Childhood Strokes

Cho, Seong Chan; Ha, Sang Bae

Abstract

OBJECTIVE
We documented childhood strokes in this hospital to ascertain the causes of childhood strokes and the proportion of stroke types. METHOD: We reviewed the medical records and brain imaging studies of all children with possible strokes who were admitted to Asan Medical Center from 1990 to 1999. Our review of charts identified 131 acute childhood stroke patients aged from one to eighteen years old.
RESULTS
Seventy boys (53.4%) and 61 girls (46.6%) were involved in this study. The predominant diagnoses responsible for the stroke were arteriovenous malformation (42.0%) and moyamoya disease (24.4%). The diagnoses of 30 stroke patients (22.9%) were undetermined, 16 of them were ischemic and 14 hemorrhagic. The total number of hemorrhagic stroke was almost twice as that of ischemic stroke. As patients aged, the incidence of ischemic stroke decreased while the opposite trend was observed in hemorrhagic stroke. There were 14 death (10.7%) consisting of 13 hemorrhagic stroke patients and 1 ischemic during the admission period. Relapse of stroke were noted in 19 of 131 patients (14.5%) with the main cause being arteriovenous malformation.
CONCLUSION
Although the main diagnoses of childhood strokes were arteriovenous malformation and moyamoya disease, the cause of strokes in 23% could not be confirmed. The incidence of ischemia decreased while that of hemorrhage increased with the increase in age. Death, relapse, and complication occurred more frequently in hemorrhagic than ischemic stroke.