Stroke in children with sickle cell anaemia in Sokoto: a ten-year review
Keywords:
Paediatric stroke, Sickle cell anaemia, Late Presentation, OutcomeAbstract
Objective: Stroke (cerebrovascular accident) generally occurs more often in children than once suspected, with its attendant potential consequences. It is an under recognized cause of neurologic disabilty in children, with varied causes. Stroke is a devastating and potentially life threatening complication of sickle cell anaemia (SCA). Children with sickle cell haemoglobinopathy have a life time increased risk of developing a stroke. This study aims to assess the pattern of stroke presentation among SCA children in Sokoto, North-Western Nigeria.
Methodology: A review of all the clinical records of children with SCA who were diagnosed and managed for sickle cell related stroke at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto; Nigeria, over a ten-year period (May, 2004 – April, 2014) was undertaken. Data analysis was done using the statistical package for social sciences (SPSS) version 20.
Results: Fifteen cases of Paediatrics stroke were identified, out of a total of 416 registered children with SCA, giving a stroke prevalence of 3.6%. Male: Female ratio was 1:1. All the stroke cases were of haemoglobin SS electrophoresis; with a mean age at diagnosis of SCA of 2.2 (±1.5) years and mean age at stroke onset of 6.3 (±2.8) years. Mean time of hospital presentation after the stroke onset was 10 (±2.5) days. Hemiparesis and expressive aphasia were the predominant presenting features. Based on the neuroimaging findings, majority of the stroke types were infarctive (71.4%). No mortality was recorded.
Conclusion: The prevalence of sickle cell related childhood stroke of 3.6% in this series is relatively low. Majority of the patients presented to hospital very late, after the stroke onset. There is therefore the need for increased awareness on childhood stroke in our community, in order to facilitate early hospital presentation and prompt management to improve the outcome.
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