Childhood Stroke in Rivers State: A Clinical and Aetiological Evaluation at the University of Port Harcourt Teaching Hospital, Nigeria

Abstract

Background: A cerebrovascular accident (stroke) is a medical emergency that can lead to irreversible brain damage or death. It is a cause of disability and poor quality of life among the paediatric population. This study aims to determine the clinical features and aetiology of stroke in children. Settings and Design: This descriptive observational study was conducted at a public tertiary hospital in Southern Nigeria. Materials and Methods: This study was conducted in the children's medical wards of the University of Port Harcourt Teaching Hospital from January 2023 to December 2024.  A total of 28 children with a diagnosis of stroke were included in the study.  Diagnosis was made based on their clinical history, laboratory, radiologic investigations, and clinical examinations. Demographic data, clinical presentation, risk factors, and investigations for risk factors were obtained from the patient’s case notes and entered into a proforma.  Data was analysed using SPSS version 25. Results: Participants were twenty-eight children (Male: Female = 1.5:1), their ages ranged from 6 months to 16 years. Sixteen (57.1%) of them were 5 years and below, and 26 (92.9%) had ischaemic stroke. The primary presenting complaints includes limb weakness (85.7%), fever (71.4%), headaches and convulsions (57.1%), and coma (10.7%). Eleven patients (39.3%) had co-morbidities. The common radiologic finding was cerebral infarction, central nervous system infection (46.4%) was the most commonly identified aetiology followed by sickle cell anaemia (28.6%) while overall mortality was 7.1% (2 cases). There was delay in presentation and in making radiologic diagnosis. Conclusion: Cerebrovascular accident is not uncommon among children and infectious causes remain a critical cause in this region. Measures to prevent infection of the CNS are crucial to reduce the morbidity and mortality associated with childhood stroke.