Ischemic stroke in children is a rare yet serious condition with high risk of morbidity and long-term neurological sequelae. Early diagnosis and management are often challenging due to subtle clinical presentations and the wide differential diagnoses in pediatric patients. We report a case of a 2-year-old girl who presented with persistent left-sided hemiparesis first noticed at the age of 9 months. MRI revealed chronic infarction in the right corona radiata and lentiform nucleus. Magnetic resonance venography (MRV) suggested left transverse sinus thrombosis. There was no evidence of cardiac abnormalities, thrombophilia, or infection. The patient was diagnosed with chronic ischemic stroke and underwent regular physiotherapy. One year later, she developed generalized tonic-clonic seizures. EEG findings supported the diagnosis of epilepsy with structural etiology. Laboratory investigations revealed vitamin D insufficiency, which may have contributed to post-stroke epilepsy. This case underscores the complexity of diagnosing pediatric stroke, particularly when presentation is delayed. Arteriopathy and cerebral venous sinus thrombosis were the most likely causes. Risk factors for post-stroke epilepsy in this case include neurological deficits, cortical involvement, and low vitamin D levels. Early neuroimaging, appropriate rehabilitation, and long-term monitoring are essential in optimizing neurological outcomes. Pediatric stroke, though uncommon, can lead to significant disability if not identified and managed early. This case illustrates the importance of timely neuroimaging and long-term follow-up, especially in children under one year of age who are at increased risk of poor outcomes and epilepsy.
| Published in | American Journal of Pediatrics (Volume 11, Issue 2) |
| DOI | 10.11648/j.ajp.20251102.20 |
| Page(s) | 101-107 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2025. Published by Science Publishing Group |
Pediatric Ischemic Stroke, Hemiparesis, Post-stroke Epilepsy, Cerebral Infarction, Arteriopathy, Transverse Sinus Thrombosis, Vitamin D Insufficiency
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APA Style
Kinasih, N. M. P. L., Suwarba, I. G. N. M., Mahalini, D. S. (2025). Ischemic Stroke in Children a Case Report. American Journal of Pediatrics, 11(2), 101-107. https://doi.org/10.11648/j.ajp.20251102.20
ACS Style
Kinasih, N. M. P. L.; Suwarba, I. G. N. M.; Mahalini, D. S. Ischemic Stroke in Children a Case Report. Am. J. Pediatr. 2025, 11(2), 101-107. doi: 10.11648/j.ajp.20251102.20
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Download@article{10.11648/j.ajp.20251102.20,
author = {Ni Made Praba Laras Kinasih and I Gusti Ngurah Made Suwarba and Dewi Sutriani Mahalini},
title = {Ischemic Stroke in Children a Case Report
},
journal = {American Journal of Pediatrics},
volume = {11},
number = {2},
pages = {101-107},
doi = {10.11648/j.ajp.20251102.20},
url = {https://doi.org/10.11648/j.ajp.20251102.20},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251102.20},
abstract = {Ischemic stroke in children is a rare yet serious condition with high risk of morbidity and long-term neurological sequelae. Early diagnosis and management are often challenging due to subtle clinical presentations and the wide differential diagnoses in pediatric patients. We report a case of a 2-year-old girl who presented with persistent left-sided hemiparesis first noticed at the age of 9 months. MRI revealed chronic infarction in the right corona radiata and lentiform nucleus. Magnetic resonance venography (MRV) suggested left transverse sinus thrombosis. There was no evidence of cardiac abnormalities, thrombophilia, or infection. The patient was diagnosed with chronic ischemic stroke and underwent regular physiotherapy. One year later, she developed generalized tonic-clonic seizures. EEG findings supported the diagnosis of epilepsy with structural etiology. Laboratory investigations revealed vitamin D insufficiency, which may have contributed to post-stroke epilepsy. This case underscores the complexity of diagnosing pediatric stroke, particularly when presentation is delayed. Arteriopathy and cerebral venous sinus thrombosis were the most likely causes. Risk factors for post-stroke epilepsy in this case include neurological deficits, cortical involvement, and low vitamin D levels. Early neuroimaging, appropriate rehabilitation, and long-term monitoring are essential in optimizing neurological outcomes. Pediatric stroke, though uncommon, can lead to significant disability if not identified and managed early. This case illustrates the importance of timely neuroimaging and long-term follow-up, especially in children under one year of age who are at increased risk of poor outcomes and epilepsy.
},
year = {2025}
}
TY - JOUR T1 - Ischemic Stroke in Children a Case Report AU - Ni Made Praba Laras Kinasih AU - I Gusti Ngurah Made Suwarba AU - Dewi Sutriani Mahalini Y1 - 2025/06/12 PY - 2025 N1 - https://doi.org/10.11648/j.ajp.20251102.20 DO - 10.11648/j.ajp.20251102.20 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 101 EP - 107 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20251102.20 AB - Ischemic stroke in children is a rare yet serious condition with high risk of morbidity and long-term neurological sequelae. Early diagnosis and management are often challenging due to subtle clinical presentations and the wide differential diagnoses in pediatric patients. We report a case of a 2-year-old girl who presented with persistent left-sided hemiparesis first noticed at the age of 9 months. MRI revealed chronic infarction in the right corona radiata and lentiform nucleus. Magnetic resonance venography (MRV) suggested left transverse sinus thrombosis. There was no evidence of cardiac abnormalities, thrombophilia, or infection. The patient was diagnosed with chronic ischemic stroke and underwent regular physiotherapy. One year later, she developed generalized tonic-clonic seizures. EEG findings supported the diagnosis of epilepsy with structural etiology. Laboratory investigations revealed vitamin D insufficiency, which may have contributed to post-stroke epilepsy. This case underscores the complexity of diagnosing pediatric stroke, particularly when presentation is delayed. Arteriopathy and cerebral venous sinus thrombosis were the most likely causes. Risk factors for post-stroke epilepsy in this case include neurological deficits, cortical involvement, and low vitamin D levels. Early neuroimaging, appropriate rehabilitation, and long-term monitoring are essential in optimizing neurological outcomes. Pediatric stroke, though uncommon, can lead to significant disability if not identified and managed early. This case illustrates the importance of timely neuroimaging and long-term follow-up, especially in children under one year of age who are at increased risk of poor outcomes and epilepsy. VL - 11 IS - 2 ER -
Pediatric Medical Faculty, Udayana University, Pediatric Department Ngoerah Hospital, Denpasar, Indonesia
Pediatric Medical Faculty, Udayana University, Pediatric Department Ngoerah Hospital, Denpasar, Indonesia
Pediatric Medical Faculty, Udayana University, Pediatric Department Ngoerah Hospital, Denpasar, Indonesia
