Dr. Anum Ahad, Dr Syeda Tehreem Fatima Kazmi, Dr. Danial Tahir
Aim: The aim was to investigate the etiological factors, clinical features, neuro-radiological results in infants and children with ischemic stroke.Study design: This is a descriptive study.Place and Duration: In the Pediatric Neurology department of Mayo Hospital Lahore for one-year duration from January 2019 to December 2020.Method: The study included children with weakness, sensory convulsions or any focal deficit. All these children underwent computed tomography. People with evidence of myocardial infarction were examined for clinical features, etiologic factors and results. People with neurological infection, trauma, brain tumor and abscess were excluded from the study. SPSS 18 software was used for data analysis. Results: The study included 30 patients. The age range was from two months to twelve years. The male-female ratio was between 3.3 and 1. Sixteen (53%) were between 6 and 12 years old, 12 (40%) were between 2 and 5 years old, and only 2 (6.6%) was less than one year old. Etiological factors were detected in 12 patients (40%), most of them had cardiac pathology, i.e. 10 (33.3%). There were 2 (6.6%) patients with protein C and S deficiency and no predisposing factor was detected in 18 (60%) patients. The clinical picture was examined and 29 (96.6%) patients with hemipheresis were found. Fifteen children (56%) had facial weakness. While 16 (53.3%) patients had convulsions, 11 (13%) were unconscious. Thirteen (43%) were hectic at the time of application. There were seven (23%) difficulty swallowing, 4 (13.3%) headaches and only 3 (10%) vision problems. Central cerebral artery infarction was more common in 19 cases (63.3%). Anterior cerebral infarction was in 4 (13.3%), and only 2 (6.6%) had posterior cerebral infarction. Complications were also studied in these patients. Eighteen patients (60%) had seizures. Nine (30%) developed mild or severe chest infections, and 10 (33.3%) later developed urinary tract infection. Weight loss was observed in 11 patients (36.6%). The result was tested using Glasgow Coma Scale. Ten (33.3%) patients gave good results, 14 patients (46.6%) had moderate disability, and 4 patients (13.3%) had severe disability, 2 (6.6%) died.Conclusion: Ischemic stroke has been found to be not uncommon in Pakistani children. Heart disease is the most important and avoidable factor predisposing to ischemic stroke. Every effort should be made to diagnose and treat congenital heart disease as soon as possible. Middle cerebral artery infarction is the most common infarction. Computed tomography turned out to be a very useful and sensitive test in the diagnosis of ischemic infarction. If possible, brain imaging should be performed in children with suspected stroke. Although the mortality rate was low, the survival rate among survivors was quite high. Because this is a hospital trial and may not represent a general pediatric age group, large-scale population studies for the future should be planned. Key words: ischemic stroke, children, computed tomography.