Researchers at University of Utah, Salt Lake City, performed a retrospective study of 10,236 children hospitalized and discharged with a diagnosis of hemorrhagic or ischemic stroke in the USA during years 2000 and 2003. Demographics, predisposing conditions, and intensive or aggressive care were compared by type of stroke and hospital, Children's or non-Children's. Hemorrhagic stroke, occurring in 43% of stroke discharges, was more common in younger children (60% of all infant strokes), and had a higher mortality. Ischemic stroke was more common in older children (50% in children >10 years of age), and more frequently associated with a predisposing condition (leukemia, congenital heart disease, sickle cell anemia). Rates of intensive (mechanical ventilation, advanced monitoring) and aggressive (pharmacological therapy or invasive interventions) care were 30% at Children's and 15% at non-Children's Hospitals, and similar by stroke type. Older children, those with hemorrhagic stroke and predisposing conditions, and those treated at a Children's Hospital received aggressive care. Inhospital mortality (11% with hemorrhagic stroke and 7% ischemic stroke) was associated with hemorrhagic stroke and aggressive care. [1]

COMMENT. Pediatric stroke patients receive similar acute care for hemorrhagic or ischemic stroke. Intensive and aggressive care is provided infrequently but is more common at Children's than non-Children's Hospitals. Mortality is relatively high (7- 11%) and might be reduced by implemention of recently published treatment recommendations. [2, 3, 4]

Moyamoya disease in early infancy [5]. A 2-month-old boy presenting with stroke secondary to moyamoya disease, and successfully treated with revascularization surgery at age 3 months is reported from the Medical College of Wisconsin, Milwaukee, WI. A rare occurrence in infancy, moyamoya patients are at risk of further ischemic events.