Causes and clinical presentation of stroke in children in Cameroon

Objective: The aim was to determine the aetiological factors and clinical and paraclinical aspects of stroke in children in Cameroon.Design: retrospective study of the recordsSetting: At two university hospitals in the city of Yaoundé (Yaoundé Gynaeco-Obstetric and Paediatric Hospital and the Chantal Biya Foundation Mother and Child Centre)Participants: 47 children with stroke for seven and half yearsInterventions: Data were collected from medical records. The variables studied included clinical and paraclinical data.Main outcome measures: Key variables were summarised in the form of mean ± standard deviation, frequencies and percentagesResults: The mean age was 6.5+2.8 years. The Male Female sex ratio was 1.8:1. The average consultation time was 31.8 hours. Hemiplegia/hemiparesis (95.7%) was the main clinical manifestation, associated with signs such as convulsions (27.7%), fever (46.8%) and pallor (27.7%). Ischaemic and haemorrhagic stroke accounted for 41 cases (87.2%) and 6 cases (12.8%), respectively. The aetiological factors for ischaemic stroke were sickle cell disease (72.3%), sepsis (4.2%), protein S deficiency (2.1%) and dilated cardiomyopathy with mitral insufficiency (2.1%). The aetiology was not found in 3 patients (6.4%) with ischaemic stroke. Apart from sickle cell disease (66.6%), the aetiological factors for haemorrhagic stroke were idiopathic thrombocytopenic purpura (16.7%) and haemophilia B (16.7%). Ischaemia mainly involved the middle cerebral artery (86.1%). Haemorrhagic attacks were mainly supratentorial.Conclusion: In urban Cameroon, strokes frequently occur around the age of 6, with a predominance of ischaemic strokes resulting in motor deficits. Sickle cell disease is the most common cause.