Clinicaetiologicall, neuroradiological findings, epilepsy development and factor affecting neurological prognosis in childood acute arterial stroke

Objective: Stroke is a clinical picture of focal cerebral damage and neurological loss due to sudden occlusion or rupture of brain arteries or veins. Cognitive and motor disorders may occur in children with stroke or stroke may recur. Therefore, in this study, we aimed to investigate the etiologic, clinical, radiological features, the factors affecting neurological prognosis, development of epilepsy of the patients followed up with the diagnosis of acute arterial stroke. Materials and Methods: The files of the patients diagnosed as acute arterial stroke who were followed up in the Pediatric Neurology Department of CUTF Balcali Hospital between 2004 and 2019 were retrospectively analyzed. 43 patients were included in the study. Demographic data, risk factors, admission symptoms, neuroimaging characteristics, acute stroke treatment and prophylactic treatments, and recent neurological and cognitive status of the patients were collected. Results: 53.5% of the patients were male and 46.5% were female. The median age at diagnosis was 120 months (minimum 1 month, maximum 207 months). Prothrombotic causes were 55.8% , cardiac and hematological causes were 32.6% and arteriopathies were 23.2% . 41.9% of the patients had multiple risk factors. 74.4% of the patients presented with focal neurological symptoms, 25.6% with generalized symptoms and 37.2% with seizures. Twenty-four patients developed epilepsy during follow-up. Epilepsy was more frequent in patients presenting with seizures and having frontotemporal involvement (p <0.05). 60.5% of the patients had neurological sequelae during follow-up. Sequelae was more frequent in patients with stroke in younger age, who presented with focal symptoms and those with parietal involvement (p <0.05). 16.3% of the patients had stroke recurrence. Recurrence was more frequent in patients with prothrombotic risk factors (p <0.05). Conclusion: Stroke is an important cause of long-term mortality and morbidity. To determine the risk of recurrence of stroke and appropriate treatment in each patient, it is important to recognize the diseases that cause AIS.