Childhood arterial ischemic stroke in Egypt

Arterial ischemic stroke (AIS) in neonates and children is a major cause of significant morbidity and mortality.1–4 Although considered rare, estimates place the incidence of AIS at 2.7 per 100 000 children, which is comparable to the incidence of brain tumors in children.5 Unlike brain tumors however, there is no comprehensive, multi-institutional approach to understand the pathophysiology and improve the management of childhood AIS. Our understanding of the epidemiology of childhood AIS in Egypt is limited. Judging by the largest cohort of childhood stroke available, the majority of children with AIS presented in association with a recognized risk factor.6 However, over one third of cases occur in otherwise well children.6 Recent interests have focused on thrombophilia as a cause of AIS in these children.7 Thrombophilic states may lead to a reduced threshold for pathological thrombus formation in cerebral vessels presenting with AIS in children.8 An association between thrombophilia and AIS may warrant development of primary and secondary thromboprophylactic strategies as prevention of childhood AIS. To gain a greater understanding of epidemiology, risk factors including thrombophilic abnormalities, and outcome of childhood AIS in Egypt, we reviewed all cases of AIS admitted to the EL Mataryia Teaching Hospital, Cairo, Egypt 2004–2008.