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Journal of Tropical Pediatrics Advance Access published online on April 24, 2006
Journal of Tropical Pediatrics, doi:10.1093/tropej/fml016
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© The Author [2006]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Original Papers

Stroke in Childhood: Experience in Istanbul, Turkey

Nur Aydinli 1, Burak Tatli 1 *, Mine Çaliskan 2, Meral Özmen 1, Agop Citak 3, Aysegul Unuvar 4, Tolunay Baykal 5, Rukiye Eker Omeroglu 6, Kubilay Aydin 7, Serra Sencer 7, Altay Sencer 8, and Talat Kiris 8

1 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
2 Division of Pediatric Neurology, Child Healthy Institute, Istanbul, Turkey
3 Division of Pediatric Critical Care, Child Health Institute, Istanbul, Turkey
4 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
5 Division of Metabolism and Nutrition, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
6 Division of Pediatric Cardiology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
7 Department of Radiodiagnostics, Division of Neuroradiology, Istanbul Medical Faculty, Istanbul, Turkey
8 Department of Neurosurgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

* To whom correspondence should be addressed.
Burak Tatli, E-mail: buraktat{at}yahoo.com


  Abstract

Our objective was to characterize the etiologic factors and outcome for stroke in children. We retrospectively reviewed the charts of patients between the ages of 40 days and 94 months (36.5 ± 23.7 months) with stroke seen at Istanbul Medical Faculty, Department of Pediatrics between January 1995 and December 2003. We found 79 cases of stroke: 57 ischemic and 22 hemorrhagic strokes. Seventeen children had vitamin K deficiency dependent hemorrhage. In 14 children stroke occurred as a complication of cardiac disease, 7 had moyamoya disease, 3 had protein C deficiency, 2 had thalassemia, 2 had hyperhomocysteinemia (methylene tetrahydrofolate reductase gene mutation), 2 were heterozygote for factor V Leiden, 3 had Down's syndrome, 1 was diagnosed with antiphospholipid syndrome, 1 had glycogen storage disease, and in 28 children no underlying cause could be found. Multiple risk factors were found in 4 children. The outcome in all 79 stroke patients was as follows: asymptomatic 60%; symptomatic epilepsy or persistent neurologic deficit 37%; death 3%; and recurrent stroke 5%. Thus, an underlying cause for stroke was identified in 65% of the children in the study group; 40% of the children either died or suffered motor and/or cognitive sequelae.


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