Pediatrics: Stroke and metabolic disorders

Stroke is more common in boys than girls even after controlling for differences in frequency of causes trauma and these appears to be a predominance of stroke in black children. This difference remains true even after accounting for sickle cell disease patients with stroke and moreover seizures are common in both ischemic and hemorrhagic strokes. They occur in up to 50% of children with strokes are not restricted to any age group and are not limited to any specific seizure type. A stroke or cerebral vascular accident (CVA) in children is typically considered to be a rare event. The reported incidence of combined and hemorrhagic ischemic pediatric stroke ranges from 1.2 to 13 cases per 100,000 children under 18 years of age.

Non-contrast head computed tomography (CT) is sensitive for acute bleeding and should be obtained emergently to exclude a cause for hemorrhagic stroke. Despite increasingly advanced imaging techniques, the adult literature suggests that a lumbar puncture is still needed to rule out a subarachnoid hemorrhage.

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