Dr Antricsh Kumar1, Dr Dhan Raj Bagri1, Dr. J.N. Sharma1
1 Department of Pediatrics, Sir Padampat Institute of Neonatal and Child Health, SMS Medical College, Jaipur, Rajasthan
Paediatric stroke is rare; recent studies estimate it’s prevalence to be around 1,72 in 100,000 a year in North America.1 To better understand childhood stroke, a group of doctors within the Department of Paediatrics at Sawai Man Singh (SMS) Medical College in Jaipur, India, set out to investigate the profile of childhood stroke at their hospital.
SMS Medical College opened in 1947 and, since then, now provides medical training to students across multiple attached speciality hospitals.2 Within the Department of Paediatrics, the research team explored patterns in clinical presentation, aetiology and neuroimaging in children who presented to their hospital with stroke from June 2019 to December 2019. “Over a 7-month period we recruited 75 children with childhood stroke.” said Dr. Bagri, Assistant Professor in the Department of Paediatrics “Neuroimaging showed that 72.2% of cases were acute ischaemic stroke, 5.3% were haemorrhagic and cerebral venous thrombosis in 12%”.
Left to right: Dr Nishant (Senior Resident), Dr J N Sharma (Senior Professor), Dr Dhan Raj Bagri (Assistant Professor).
Patient characteristics showed that age ranged from 6 months and 18 years, with 52% of the group aged between 6 months and 5 years. In addition, the majority of our cohort were males (65.3%). “We saw that most of our cohort were in early childhood and were male.” Explained Dr Bagri.
The most common clinical presentation of childhood stroke at SMS Medical College was hemiplegia, closely followed by fever (Figure 1). “We saw hemiplegia, fever, seizures, headache and altered consciousness in over half of our population” explained Dr. Bagri. “Of note, we also saw that 67% of our cohort had a comorbidity, with central nervous system infections being the most common (53%)”
Figure 1. Pie chart to show clinical presentation of childhood stroke (% showing symptom)
The researchers hope their research will provide more clinical and etiological information on paediatric stroke, particularly in India.
1 deVeber GA, Kirton A, Booth FA, Yager JY, Wirrell EC, Wood E, Shevell M, Surmava AM, McCusker P, Massicotte MP, MacGregor D, MacDonald EA, Meaney B, Levin S, Lemieux BG, Jardine L, Humphreys P, David M, Chan AK, Buckley DJ, Bjornson BH. Epidemiology and Outcomes of Arterial Ischemic Stroke in Children: The Canadian Pediatric Ischemic Stroke Registry. Pediatr Neurol. 2017 Apr;69:58-70.