الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Background: The word stroke is used to refer to a rapidly developing focal or global neurological deficit lasting more than 24 hours if it has a vascular basis. The term “children” is between one month and 18 years of age. In adults, etiology and outcome of stroke is well known, but it is quite few information about children especially in Egypt. The studies of stroke in children are few with variable results and under estimation of hemorrhagic stroke. The aim of this study was to delineate the different characteristics of stroke in children and their outcome. Patients and Methods: An informed consent was taken from at least one of each child parents. This study was conducted on sixty clinically diagnosed strokes in children patients obtained from Mansoura University Hospitals and other governmental hospitals in Mansoura from July 2011 till April 2016. With the following Inclusion criteria: stroke in children between one and 18 years of age, both hemorrhagic and ischemic strokes in children and both parenchymatous and non parenchymatous stroke in children. Exclusion criteria: includes stroke in the first year of life, in hospital stroke in children and hemorrhagic brain tumors in children. All patients were subjected to the following: Detailed history, including previous medical diseases and hospital delay duration in hours (<6 hours, 6-12 hours, 12-24 hours, 24-48 hours and >48 hours). General examination: with the following clinical items that should be considered in the diagnosis of stroke in children: Body mass index, measurement of head circumfe the skin should be examined for rash, signs of trauma, splinter haemorrhage or embolic skin rash and detailed cardiovascular examination including blood pressure. Neurological examination: Pediatric (NIHSS) at three points (on admission, on discharge and three months later), funduscopic examination for papilloedema or hemorrhage and (mRS) for children at three points (on admission, on discharge and three months later). Laboratory investigations and radiological examination: Chest x-ray, electrocardiogram, echocardiogram, brain computed tomography, brain magnetic resonance imaging. Results: Most of patients (34 (56.7%) arrived to hospital within 12-48 hours, 16 (26.7%) patients were arrived after 48 hours while only 10 (16.7%) patients were arrived before 12 hours. Etiologically, most of patients, 23 (38.3%) were cryptogenic and there is a highly significant improvement in severity and outcome of stroke in children with time with significant weak positive correlation between severity of stroke at the onset and disability outcome three months later. Conclusion: In conclusion, diagnosis of stroke in children proves challenging, because symptoms are often unspecific in nature which reflected on hospital delay time, etiology is diverse and different from those present in adulthood. Our limitations were the unawareness of the disease and short follow up time. Our study was unfunded to clarify the various and rare genetic causes seen in stroke in children.