Medical and autopsy records, and brain imaging studies of 178 children with possible stroke within the Greater Cincinnati metropolitan area child population of almost 300,000 during 1988 and 1989 were reviewed in the Departments of Neurology and Neuroradiology, University of Cincinnati and Children’s Hospital Medical Centers. Stroke occurred in 16 cases (13 whites and 3 blacks), with an overall yearly incidence rate of 2.7 strokes per 100,000 children. The rate was similar for blacks and whites and for boys and girls. The combined incidence rate for intracerebral and subarachnoid hemorrhage of 1.5 per 100,000 was slightly greater than the rate for cerebral infarction of 1.2 per 100,000. Hemorrhagic stroke was related to arteriovenous malformation in 3 cases, cavernous hemangioma in 2, hypothalamic glioma in 2, and aneurysm in one. Mortality for hemorrhagic stroke was 22% as compared to 14% for cerebral infarction. 
COMMENT. In 81 children < 17 yrs of age evaluated for stroke at the Medical College of Georgia, hemorrhagic stroke occurred in only 16 (20%), of whom 12 had intracerebral and 4 subarachnoid hemorrhage. Seizures occurred in 47%, and were recurrent in 26%. A late onset of seizures and cortical infarction were risk factors for recurrent seizures.