Caracterización de los casos de ACV hemorrágico en la población pediátrica mayor de 1 mes en un hospital pediátrico de alta complejidad en la ciudad de Bogotá, Colombia durante los años 2012 a 2017

Introduction: After reviewing the clinical literature, there are no data that indicate the proportion of childhood stroke compared to the general population, generating gaps in knowledge and the impact of this condition. Additionally, more than 40% of patients suffering from this pathology present an important degree of disability and a fourth part of them also die secondarily. Moreover, it is a pathology of great importance, since it is part of the ten main causes of death in children. Objectives: To describe the clinical, radiological, treatment and outcomes of hemorrhagic stroke in the pediatric population in a high complexity pediatric hospital between 2012 and 2017-I. Methods: During 2012 to 2017-I we retrospectively reviewed the clinical histories of children, older than 1 month and under 18 years, who were admitted at the hospital due to hemorrhagic stroke, based on a specific instrument that allows the variables to be collected. The variables included in the study were analyzed, obtaining the relative frequencies of the demographic, clinical, epidemiological characteristics and outcomes. Results: We reviewed 283 clinical histories and after applying the exclusion and revision criteria, 55 patients were obtained as study population. Most of the patients were teenager between 9 and 14 years of age. Intraparenchymal hematoma was the most frequent tomographic finding and hematologic causes such as leukemia, hemophilia and other bleeding and coagulation disorders occupied about 40% of the etiology of the events and in 25% of cases it was not possible to diagnose a related etiology. In less than half of the cases, the management of the pathology was surgical. The mortality of the patients was 38% of the cases and the severe disability was around 12.8%, measured with the Rankin scale of 3 to 5. There may be some statistically significant relationship between the neurological status, the volume of the hematoma and the modified Rankin scale. Conclusions: The increased risk of hemorrhagic stroke in the pediatric population was confirmed in patients with malignancies and blood dyscrasias; also, its great impact on public health and economic costs due to its great morbidity and disability.This is one of the first descriptive studies for this underestimated disease. Colombia does not have clear statistics on this problem, so more studies are required to expand the correlations and prognoses of this pathology.