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Research ArticleOriginal Article
Open Access

Perinatal stroke in Saudi children. Clinical features and risk factors

Mustafa A. Salih, AbdelGalil M. Abdel-Gader, Ahmed A. Al-Jarallah, Amal Y. Kentab, Ibrahim A. Alorainy, Hamdy H. Hassan and Mohammed N. Al-Nasser
Saudi Medical Journal March 2006, 27 (3 Supplement) S35-S40;
Mustafa A. Salih
Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, PO Box 2925, Riyadh 11461, Kingdom of Saudi Arabia. Fax. +966 (1) 4679463. E-mail: [email protected]
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  • For correspondence: [email protected]
AbdelGalil M. Abdel-Gader
Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Ahmed A. Al-Jarallah
Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Amal Y. Kentab
Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Ibrahim A. Alorainy
Department of Radiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Hamdy H. Hassan
Department of Radiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Mohammed N. Al-Nasser
Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Abstract

OBJECTIVE: To describe the clinical features and presentations of perinatal stroke in a prospective and retrospective cohort of Saudi children and ascertain the risk factors.

METHODS: Patients with perinatal stroke were identified from within a cohort of 104 Saudi children who were evaluated at the Division of Pediatric Neurology at King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia from July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Neuroimaging for suspected cases of stroke consisted of cranial CT, MRI, or both.

RESULTS: During the study period, 23 (22%) of 104 children (aged one month to 12 years) were diagnosed to have had perinatal stroke. The male:female ratio was 1.6:1. Ten (67%) of the 15 children who had unilateral ischemic involvement had their lesion in the left hemisphere. The presentation of the ischemic result was within 24-72 hours of life in 13 (57%) patients, and in 6 children (26%), motor impairment was recognized at or after the age of 4 months. Nine children (39%) had seizures at presentation. Pregnancy, labour, and delivery risk factors were ascertained in 18 (78%) cases. The most common of these included emergency cesarean section in 5 cases, and instrumental delivery in another 5. Screening for prothrombotic risk factors detected abnormalities in 6 (26%) patients on at least one test carried out between 2 months and 9 years of age. Four children (17%) had low protein C, which was associated with low protein S and raised anticardiolipin antibodies (ACA) in one patient, and low antithrombin III in another. Low protein S was detected in a 42-month-old boy. The abnormality in the sixth child was confined to raised ACA.

CONCLUSION: The present study highlights the non-specific features by which stroke presents during the neonatal period. The data are in keeping with the potential role for inherited and acquired thrombophilia as being the underlying cause. However, the high prevalence of additional acquired antenatal and perinatal risk factors support a multifactorial disorder.

  • Copyright: © Saudi Medical Journal

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Saudi Medical Journal: 27 (3 Supplement)
Saudi Medical Journal
Vol. 27, Issue 3 Supplement
1 Mar 2006
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Perinatal stroke in Saudi children. Clinical features and risk factors
Mustafa A. Salih, AbdelGalil M. Abdel-Gader, Ahmed A. Al-Jarallah, Amal Y. Kentab, Ibrahim A. Alorainy, Hamdy H. Hassan, Mohammed N. Al-Nasser
Saudi Medical Journal Mar 2006, 27 (3 Supplement) S35-S40;

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Perinatal stroke in Saudi children. Clinical features and risk factors
Mustafa A. Salih, AbdelGalil M. Abdel-Gader, Ahmed A. Al-Jarallah, Amal Y. Kentab, Ibrahim A. Alorainy, Hamdy H. Hassan, Mohammed N. Al-Nasser
Saudi Medical Journal Mar 2006, 27 (3 Supplement) S35-S40;
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© 2023 Saudi Medical Journal Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention.  Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3175. Print ISSN 0379-5284.

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