Etiology, clinical characteristics and prognosis of spontaneous intracerebral hemorrhage in children: A prospective cohort study in China.

BACKGROUND AND OBJECTIVE

Much is known about spontaneous intracerebral hemorrhage (SICH) in adults, but few studies have examined pediatric SICH, especially in China. The aim of the present study was to describe the etiology, clinical characteristics and prognosis of SICH in children from southwest China.

METHOD

Consecutive patients aged 1-18 years with SICH at our medical center were prospectively enrolled from January 2012 to June 2014. SICH was defined by WHO criteria and confirmed by CT or MRI findings. Demographic and clinical information was collected at baseline, and follow-up assessments were conducted at 3 and 6 months after SICH, when patients were scored on the modified Rankin Scale (mRS) and events of deaths and recurrent hemorrhagic stroke were recorded.

RESULTS

Among the 70 children (43 males; median age, 12.0 years) in the final analysis, 44 patients (62.9%) had SICH due to arteriovenous malformation, and less frequent etiologies were cavernous malformation (n=4), aneurysm (n=2), tumors (n=2), moyamoya (n=2), hemophilia (n=1), hypertension (n=1), while 14 (20.0%) had SICH of unknown etiology. The mortality rate at 3 months and 6 months was equal, which was both 3%. The rate of disability was 12.1% at 3 months and 9.1% at 6 months.

CONCLUSION

The most frequent etiology of pediatric SICH in this Chinese cohort was arteriovenous malformation. SICH of unknown etiology occurred much more often in our cohort than in previously published Caucasian patients in the US and Europe.