1985 Volume 17 Issue 4 Pages 307-313
The cerebrovascular accident in children is a rare clinical entity, epidemiologic studies of which are very scarce in Japan. This study analyzed 13, 131 sick children, admitted to a children's general hospital, with regard to the incidence of cerebrovascular accident and specific characteristics. In this paper, cases of cerebral infarction are analyzed with special reference to developmental outcome.
One hundred and twenty children (0.85 percent of all sick children) had cerebrovascular accidents documented both in the clinical pictures and CT scans. 2.5% of the 4, 738 CT examinations were performed for these sick children. There were 79 cases of intracranial hemorrhage (65.0%), 24 of cerebral infarction (20.0%) and 17 of vascular anomalies (14.2%).
Of the children with cerebral infarction, eleven (45.8%) had occlusion of the middle cerebral artery, four (16.5%) had occlusion of the internal carotid artery, six (25.0%) had occlusion of multiple arteries or diffuse lesions, two (8.4%) had lacunar type occlusions and another (4.2%) had anterior cerebral arterial occlusion. Stroke onset in these children was assumed to have occurred before one year of age in 16 cases, the cause remaining essentially unknown in the majority. With regard to mental prognosis for the children with cerebral infarction, nine of the 21 cases investigated (42.8%) had severe psychomotor retardation, with IQs below 20.
In conclusion, it should be emphasized that cerebral infarction occurring at a young age could cause severe insult to immature brain development.
