Paediatric Stroke- An Analysis on Artery of Paediatric Infarct- Lenticulostriate Arteries

Abstract

BACKGROUND Stroke is a neurological insult due to cutoff of blood supply to brain. [1] Paediatric stroke is a rare, but increasing cause of childhood morbidity. [2,3] Causes and pattern of stroke in children and newborn is different from adults. Stroke can be haemorrhagic or ischaemic or both. In India, paediatric population usually refers to children under 12 years. The purpose is to study the vascular distribution pattern and prevalence of isolated involvement of lenticulostriate arteries in acute arterial stroke among paediatric population in India using MRI. MATERIALS AND METHODS This is a cross-sectional study involving 144 paediatric patients from newborn to 12 years of age in the tertiary care medical college hospital, India. Study included patients diagnosed to have acute arterial infarct by MRI study of brain. The areas and arterial territory of the infarct were studied and analysed. Isolated involvement of medial and lateral lenticulostriate arteries were analysed. Statistical analysis was done by Chi-Square test and Fisher's exact test. RESULTS Our study shows isolated involvement of Lenticulostriate arteries accounting for 51.4% of acute arterial infarct in paediatric population. There is increased incidence of stroke in Lenticulostriate arterial territory in 0-4 years of age group (P value-0.016). Lateral lenticulostriate arteries were commonly involved than medial, which accounts for 85% of their total. CONCLUSION Involvement of vascular territory in paediatric age group is different from adults. Among paediatric arterial infarcts, Lenticulostriate arteries are commonly affected, lateral more than medial. There is increased incidence of Lenticulostriate artery infarct in 0-4 yrs. of age. Since infarct in Lenticulostriate artery accounts for more than half of acute arterial infarct in paediatric population, it can be given a special name as "Artery of Paediatric Infarct."