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Neurosciences Unit,
Institute of Child Health, The Wolfson Centre, Mecklenburgh Square,
London WC1N 2AP, UK
Correspondence to: Dr Kirkham. email: FKirkham@doctors.org.uk
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Presentation with stroke is rare in children, with an incidence
of 2.6 and 3.1/100 0000 white and black children,
respectively.1 Half are haemorrhagic, requiring immediate
transfer to a neurosurgical unit in case decompression is required.
Traditionally, ischaemic strokes have been considered to be idiopathic
and to have a good prognosis, with a low recurrence risk and good
recovery of motor function and school performance. They have not been
investigated extensively, on the basis that management would not alter.
However, there is a significant mortality,1 as well as
considerable morbidity and a risk of recurrence, none of which has been
adequately defined epidemiologically. In addition, there is now
evidence that the neurological outcome could be improved, at least in
some subgroups, by appropriate emergency management and, particularly, that recurrence might be preventable. This article proposes essential investigations and management for "good practice" in the current state of knowledge, although further research is clearly
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