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Spectrum of Intracerebral Hemorrhage in Children: a Report from PICU of a Resource Limited Country


Affiliations
1 Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
2 Department of Radiology, Aga Khan University, Karachi, Pakistan
3 Department of Surgery, Section of Neurosurgery, Aga Khan University, Karachi, Pakistan
 

Intracerebral hemorrhage (ICH) in children is a rare but disabling disease that accounts for almost half cases of stroke.We report our experience of ICH in children. Retrospective review of medical records of children (1 month-16 years) admitted in Pediatric Intensive Care Unit between January 2007 and December 2014 was done. Data collected included age, gender, presentation, examination findings, neuroimaging done (CT, MRI, and angiography) management (conservative/intervention), and outcome. Results are presented as frequency and percentages. Of the total 50 patients, 58% were male and 26% were <1 year. On presentation 44% had vomiting, 42% had seizures, and GCS < 8 while 40% had altered level of consciousness. Single bleed was present in 88%, 94% had supratentorial bleed, and 32% had intraventricular extension. 72% had bleed volume of <30mL and 8% had >60 mL. CT scan was done in 98% patients and MRI in 34%, while 6% underwent conventional angiography. 60% patients were managed conservatively, 36% underwent neurosurgical intervention, and 6% underwent radiological vascular intervention. Hematologic causes were identified in 52% patients and vascular malformations in 14% and in 26% no cause could be identified. 26% of patients expired.
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  • Spectrum of Intracerebral Hemorrhage in Children: a Report from PICU of a Resource Limited Country

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Authors

Qalab Abbas
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Qurat ul Ain Merchant
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Bushra Nasir
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Anwar ul Haque
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Basit Salam
Department of Radiology, Aga Khan University, Karachi, Pakistan
Gohar Javed
Department of Surgery, Section of Neurosurgery, Aga Khan University, Karachi, Pakistan

Abstract


Intracerebral hemorrhage (ICH) in children is a rare but disabling disease that accounts for almost half cases of stroke.We report our experience of ICH in children. Retrospective review of medical records of children (1 month-16 years) admitted in Pediatric Intensive Care Unit between January 2007 and December 2014 was done. Data collected included age, gender, presentation, examination findings, neuroimaging done (CT, MRI, and angiography) management (conservative/intervention), and outcome. Results are presented as frequency and percentages. Of the total 50 patients, 58% were male and 26% were <1 year. On presentation 44% had vomiting, 42% had seizures, and GCS < 8 while 40% had altered level of consciousness. Single bleed was present in 88%, 94% had supratentorial bleed, and 32% had intraventricular extension. 72% had bleed volume of <30mL and 8% had >60 mL. CT scan was done in 98% patients and MRI in 34%, while 6% underwent conventional angiography. 60% patients were managed conservatively, 36% underwent neurosurgical intervention, and 6% underwent radiological vascular intervention. Hematologic causes were identified in 52% patients and vascular malformations in 14% and in 26% no cause could be identified. 26% of patients expired.