[Ischemic stroke in childhood].

We have encountered 38 cases of juvenile ischemic strokes during the past 10 years, which included 16 cases of moyamoya disease and 22 cases of non-moyamoya strokes. The etiology could not be determined in most non-moyamoya strokes, except in 4 cases of cardiogenic embolism and 1 case of post-meningitic stroke. We further examined 13 cases of idiopathic strokes, which showed clinical symptoms of so-called acute infantile hemiplegia. Nine out of 13 patients developed strokes between 6 months and 2 years of age. Strong male preponderance was noted, since 11 out of 13 patients were boys. CT scan showed basal ganglionic infarction in the territory of the perforating branches of the middle cerebral artery in 12 patients. Recurrence of ischemic events occurred in none of the patients during the mean follow-up period of 48.4 months. Functional recovery was also good, since no neurological sequelae were found in 5 patients, and the other 8 disabled children were able to go to school without help and none of the children were mentally retarded. These results and a review of the literature suggest the importance of traumatic mechanisms in the etiology and pathogenesis of juvenile idiopathic ischemic strokes of the acute infantile hemiplegic type.