Background Haemorrhagic stroke (HS) accounts for nearly half of the paediatric strokes. The aetiology of HS in childhood is not well defined in the Indian context. Objectives To study the aetiological profile and short-term neurological outcome of children with HS from North India. Methods In a prospective observational study, consecutive patients >28 days to <12 years of age admitted with a diagnosis of HS were enrolled. Demography, clinical, radiological details and investigations were recorded. Short-term outcomes were assessed at three months follow-up with the Paediatric Cerebral Performance Category scale and Paediatric Stroke Outcome Measure (PSOM). Results A total of 48 children with HS were enrolled. The median age was 6 months (1–58 months), and 33 (69%) were <2 years old. Vitamin K deficiency-related bleeding disorder (VKDB, 44%), central nervous system infections (19%), arteriovenous malformations (13%) and inherited coagulation disorders (8%) were the most common risk factors for HS. VKDB and inherited coagulation disorders were more frequent in children <2 years of age, and arteriovenous malformations were more frequent in children >2 years of age (p = 0.001). During hospitalization, 21 (44%) children died. Older age, low Glasgow coma score (<8) at admission and paediatric intracerebral haemorrhage score ≥2 were associated with mortality at discharge (p = <0.05). Among survivors, 15 (56%) children had neurological deficits (PSOM >0.5) at three month follow-up. Conclusion VKDB, inherited coagulation disorders, central nervous system infections and arteriovenous malformations were the most common risk factors for HS. VKDB is the single most important preventable risk factor for HS in infants.

中文翻译：

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儿童出血性中风的病因学特征和短期神经学结果

背景 出血性中风 (HS) 占小儿中风的近一半。在印度背景下，儿童 HS 的病因并没有得到很好的定义。目的 研究印度北部 HS 儿童的病因学特征和短期神经功能结果。方法 在一项前瞻性观察性研究中，连续纳入诊断为 HS 的年龄 > 28 天至 < 12 岁的患者。记录人口统计学、临床、放射学细节和调查。短期结果在三个月的随访中使用小儿脑功能分类量表和小儿卒中结果量表 (PSOM) 进行评估。结果共纳入HS患儿48例。中位年龄为 6 个月（1-58 个月），33 人（69%）小于 2 岁。维生素 K 缺乏相关的出血性疾病 (VKDB, 44%)、中枢神经系统感染 (19%)、动静脉畸形 (13%) 和遗传性凝血障碍 (8%) 是 HS 最常见的危险因素。VKDB 和遗传性凝血障碍在 2 岁以下的儿童中更为常见，而动静脉畸形在 2 岁以上的儿童中更为常见（p = 0.001）。住院期间，21 名（44%）儿童死亡。年龄较大、入院时 Glasgow 昏迷评分低（<8）和儿科脑出血评分≥2 与出院时死亡率相关（p = <0.05）。在幸存者中，15 名（56%）儿童在 3 个月的随访中出现神经功能缺损（PSOM > 0.5）。结论 VKDB，遗传性凝血障碍，中枢神经系统感染和动静脉畸形是HS最常见的危险因素。VKDB 是婴儿 HS 最重要的可预防危险因素。