الفهرس 
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Abstract
S
UMMARY
rterial Ischemic Stroke (AIS) and Cerebral venous Sinus Thrombosis (CSVT); Hemorrhagic Stroke (HS) includes intracerebral and subarachnoid hemorrhage. Arterial ischemic stroke is more common than both cerebral venous thrombosis and hemorrhagic strokes in children. Compared to adults, childhood stroke has a different clinical presentation and a heterogeneous etiology. The treatment and prevention of stroke in children is not well studied.
The current study aimed to determine clinical and radiological factors that can predict a poor outcome in different types of pediatric stroke.
This was a retrospective medical file review that was conducted at the Pediatric Neurology Clinic- and inpatient, Children‟s Hospital,Ain Shams University Hospitals,on sixty-there Pediatric patients with a diagnosed/definite cerebrovascular event in a period of six months starting from2022 till …. 2023.
The results of our present study can be summarized as follows: In the current study, according to diagnosis, AIS was present in 71.0%, CVST was present in 21.0% and Hemorrhagic stroke was present in 11.3%. for all studied children with stroke.
A
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In this study regarding age of symptoms, Age (2-6) was 74.2%, Age (6-10) was 11.3%, Age (10-14) was 11.3% and Age (14-18) was 3.3%. In our study, the reported presenting complaint was 45.2% acute hemiplegia as initial presentation, pain in 4.8%, sensory loss, inability to week in 3.2% each, convulsion in 38.7%, loss of consciousness in 27.4%, acute headache in 8.1%, visual loss in 3.2% and Abnormal speech in4.8%. In the present study, 48.4% of the stroke children have no known stroke risk factors, the frequent risk factor was cardiac diseases in 12,9%,hematological disease in 3,2% ,Genetic causes 11.3% ,Infection was 4,8%,collagen and vascular diseases 6.5%,and family history was positive for stroke in 3.2%, for cardiac and genetic disease in 1.6%. In our study, MRI was 40.3% and CT + MRI was 59.7%. The calculated time from arrival to obtaining neuroimaging was, 2-hours from presentation to ER in 1,6%,on the same day was 59.7%, on the second day from hospital admissions in 22.6%, After 2 days was 12.9%, After 3 days, and after 1-week in 1.6%. In our study, other investigation, ECG or ECHO abnormalities were 48 (77.4%), Any bleeding profile abnormal was 59 (95.2%) and Thrombophilia profile finding was 56 (90.3%). In this study regarding type of treatment modality, Surgical( evacuation of hematoma )in9.7%, Medical
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anticoagulant was 88.7%, Radiological intervention (mechanical thrombectomy ) was 1.6% In this study the location of stroke, Anterior circulation territories in 21.3%, PCA in 19.7%, Brain stem was 1.6%, Multiple vessels occlusion were in16.4% and Unknown was 41.0%. In the present study, good outcome (no neurological deification or mild neurological deficit) was present in 35.5% and Poor outcome was present in 64.5%. There was no statistically significant relation found between outcome neither the type of stroke nor the age of symptoms with p-value = 0.877. Also, there was no statistically significant relation found between outcome of the studied patients and their presenting complain and precipitating factors, also no statistically significant relation found between outcome of the studied patients and known stroke risk factors except statistically significant increase in the percentage of patients with cardiac findings in patients with poor outcome than those with good outcome with p-value = 0.025. Moreover, there was no statistically significant relation found between outcome of the studied patients and time interval between CT and MRI, systemic examination findings and non-radiological investigations while there was statistically significant increase in the initial Ped NIHSS score in patients with poor outcome than those with good outcome with p-value <0.001.
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In our study, there was no statistically significant relation found between outcome of the studied patients and treatment modality and also type of surgical or other interventions done for the studied patient with p-value = 0.619 and 0.427; respectively. In this study, there was no statistically significant relation found between outcome of the studied patients and their vascular involvement and presence of hemorrhage. Also, according to the location of stroke, the percentage of patients with anterior circulation and multiple V was found higher in patients with poor outcome than those with good outcome with p-value <0.001 and 0.016; respectively and the percentage of patients with PCA was found higher in those with good outcome than those with poor outcome with p-value <0.001