Vascular Health and Risk Management (Jul 2022)
Pediatric Stroke from Bench to Bedside: A Single-Center Experience in Saudi Arabia
Abstract
Abdulaziz Mohammad Al-Sharydah,1 Hussain Khalid Al-Arfaj,2 Sari Saleh Al-Suhibani,1 Fahad Safran Al-Safran,2 Abdulrahman Hamad Al-Abdulwahhab,1 Saeed Ahmad Al-Jubran,1 Abdulhadi Ahmad AlSaflan3 1Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar City, Eastern Province, Saudi Arabia; 2Medical Imaging Department, King Fahd Specialist Hospital, Dammam City, Eastern Province, Saudi Arabia; 3Anesthesia Department, King Fahd Hospital of the University, Khobar City, Eastern Province, Saudi ArabiaCorrespondence: Abdulaziz Mohammad Al-Sharydah, Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, P.O. Box: 31952 (4398), Khobar City, Eastern Province, Saudi Arabia, Tel +966 566473111, Fax +966 13-8676697, Email [email protected]: Stroke is a leading cause of severe long-term disability and death worldwide. This study aimed to determine the genetic background, causative factors, and diagnostic and outcome measures of pediatric stroke in an area endemic to sickle cell disease (SCD).Patients and Methods: This retrospective review analyzed pediatric patients with acute stroke who were admitted to King Fahd Hospital of the University, Eastern Province, Saudi Arabia, between January and June 2019. We assessed 49 cases based on computed tomography (CT) and magnetic resonance imaging (MRI) findings. Patients with incomplete records or unavailable radiological images were excluded.Results: A high likelihood of familial coexistence of stroke was detected in patients with affected siblings (33%). Among various central nervous system manifestations, motor weakness (28.6%) and headache (20.4%) were the most common symptoms/signs. Hypoxic-ischemic encephalopathy (HIE) (28.6%), SCD (22.5%), and moyamoya disease (14.3%) were the most prevalent underlying etiologies. CT without intravenous contrast was the most used initial imaging technique (92.5%). An arterial blockage was more prevalent (53.4%) than a venous infarct (46.6%) (p = 0.041), while arterial ischemic stroke was more prevalent (56.5%) than hemorrhagic stroke (43.5%). The middle cerebral artery (MCA) was most affected (63.5%), followed by the anterior cerebral artery (22.7%) and posterior cerebral artery (13.6%). Most patients were managed with medical treatment (86.1%). No mortalities occurred during the initial hospital stay. The mean length of hospital stay was 12 days.Conclusion: HIE was the most prevalent etiology of pediatric stroke. Motor weakness and headache were the most common initial manifestations. Arterial ischemic stroke was more prevalent than venous or hemorrhagic stroke. Considering the rarity of pediatric stroke, future studies should be performed with a aborative effort nationally and internationally.Keywords: magnetic resonance imaging, computed tomography, ischemic stroke, hemorrhagic stroke, paediatric
