Etiologies, Management, and Outcomes of Pediatric Stroke in a Tertiary Care Center

Background Recent developments in neuroimaging and treatments, such as thrombolysis and endovascular thrombectomy, have improved across pediatric stroke diagnosis and management. However, no contemporary data exist on stroke characteristics related to clinical outcomes among Thai children. Objectives To study clinical characteristics, investigations, and treatments associated with outcomes in Thai pediatric stroke patients. Methods Methods: We enrolled children aged 28 days to 18 years with "cerebrovascular disease" recorded as ICD 10 and inpatient records from January 2011 to September 2022. Outcomes included disability at discharge (mRS grade 4-5), in-hospital mortality, and two-year recurrent stroke rate. Results Of 206 patients, 53.4% had ischemic stroke, 36.4% were hemorrhagic, and 10.1% had cerebral venous sinus thrombosis. The main presentations were weakness (49.5%), headache (35.4%), and altered consciousness (26.2%). The most prevalent etiologies for each stroke type were Moya Moya vasculopathy in acute ischemic stroke, arteriovenous malformation in hemorrhagic stroke, and medication-related such as L-asparaginase and oral contraceptives in cerebral sinus venous thrombosis. Hemorrhagic stroke had the highest mean mRS (2.76 ± 2.19, p < 0.001) and in-hospital mortality (21.3%, p Conclusion Pediatric stroke presents variably with multiple identified risk factors. Further research is needed to improve diagnosis and treatment strategies in Thai children.