[Risk factors in cerebrovascular disease in childhood].

Introduction: The etiopathogenesis of cerebrovascular diseases in paediatrics is little known and very varied. Review of the literature gives little practical information about how to investigate a paediatric patient who presents with an acute cerebrovascular illness.

Objectives: To identify the risk factors for cerebrovascular accidents in the paediatric age group in our setting and establish guidelines as to how best to act.

Patients And Methods: A retrospective study was made of the patients admitted to the Hospital San Joan de Deú in Barcelona between January 1984 and December 1995 with the diagnosis of ischemic or hemorrhagic cerebral infarct.

Results: A total of 141 cases were identified. Sixty specific causes (43.7%) were detected, of which cardiopathies made up the biggest etiological group. Risk factors for cerebrovascular disease were found in 66% of the cases. The risk factors most often identified were association with non-specific (22) and specific (varicella: 7 cases) viral infections; moderate dehydration (10); mild head injuries (10) and situations of stress (9). There were prethrombotic factors in 32.8% of the patients and anaemia in 29%. The high percentage of the anti Cytomegalovirus (67.1%) was of doubtful significance, and the percentage rose to 82.8% in the patients who died (29/35). In this study the role of hyperhomo-cysteinemia and resistance to C activated protein could not be assessed.

Conclusions: In this study we identified the risk factors for cerebrovascular disease in the paediatric age group of our population. Stroke in the paediatric age group is probably due to a combination of several risk factors which will need structured protocols for identification. It is important to recognize these causes so as to plan strategies for action during the acute phase and to prevent recurrence, as are currently available to the adult population.