Methodology: This is a retrospective observational study where case records of paediatric patients (<18 years) who had stroke associated with Hyperhomocysteinemia were studied. Over the last five years, seven were diagnosed with hyperhomocystienemia associated with paediatric stroke.
Results: Out of the seven patients, six of them presented with headache and hemiparesis, one presented with convulsions. Mean age of presentation was 9 $\pm$1.5 years. Neuroimaging in all suggested acute cerebrovascular infracts. All had elevated homocysteine levels and five had documented low vitamin B12 levels. MTHFR gene was positive in one patient. Bilateral lens dislocation was observed in three of them. Intellectual disability was observed in four of these patients, and marfanoid features were seen in three of them. All the patients were started on low dose aspirin and polyvitamin therapy. Four patients had complete recovery, one is still improving and one was lost to follow up. Recurrence was observed in one patient.
Conclusion: Commonest symptoms were headache and hemiparesis. Manifestations of hyperhomocysteinemia can start in infancy. Homocystiene estimation should be included in work up of paediatric stroke and polyvitamin therapy should be included in management.
