Stroke in children.

Background: Stroke is a major cause of disability and death in children. It can have devastating consequences for families and enormous costs to society. Although considered rare, stroke is more common in children than brain tumours. Ten percent of children suffering stroke will die as a result, and at least 50% of survivors are left with significant neurological disabilities, learning difficulties or seizures.

Objective: This article discusses risk factors, investigation, management and outcomes of ischaemic and haemorrhagic stroke in neonates and children.

Discussion: Arteriopathies and cardiac disease are the commonest risk factors for childhood arterial ischaemic stroke (AIS). The cause of perinatal AIS is poorly understood, despite affecting 1 in 4000 newborns. Sinovenous thrombosis is commonly associated with head and neck infections, and haemorrhagic stroke with arterio-venous malformations. Magnetic resonance imaging is the diagnostic investigation of choice. Treatment recommendations are extrapolated from adults due to a lack of prospective interventional studies.