Clinical Profile and Etiology of Pediatric Patients With Stroke at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia

Background/Objectives : Pediatric stroke, though rare, remains a significant cause of morbidity and mortality in children. The condition presents a diagnostic challenge due to its varied clinical manifestations, leading to frequent misdiagnosis or delayed intervention. This study aims to assess the clinical presentation, imaging findings, etiologies, and outcomes of childhood stroke in Ethiopia, with a focus on patients admitted to St. Paul's Hospital Millennium Medical College. Methods : A hospital-based, retrospective chart review was conducted. Data were collected from the medical records of patients who were treated at St. Paul's Hospital Millennium Medical College from September 11, 2014, to January 15, 2025 G.C. Results : A total of 44 pediatric stroke cases were analyzed. The most common presenting symptoms were hemiparesis/hemiplegia (79.5%) and seizures (52.3%). Infections were the leading cause (59.1%), followed by cardiac disorders in 13.7% of cases. Ischemic stroke accounted for 70.5% of cases, while hemorrhagic stroke represented 20.4%. MRI was the most frequently used imaging modality (61.3%). At discharge, 81.8% of patients had residual neurological deficits, with motor impairment being the most prevalent (75%). The mortality rate was 9.1%. Hemorrhagic stroke and altered mental status were significant predictors of poor outcomes. Conclusions : Infections, particularly bacterial meningitis, play a crucial role in stroke occurrence in this setting. The high burden of neurological sequelae highlights the importance of early rehabilitation and long-term follow-up. Strengthening pediatric stroke surveillance and optimizing management strategies are essential for improving outcomes in affected children.