Paediatric arterial ischaemic stroke: functional outcome and risk factors
Version of Record online: 18 JAN 2010
© The Authors. Journal compilation © Mac Keith Press 2010
Developmental Medicine & Child Neurology
Volume 52, Issue 4, pages 394–399, April 2010
How to Cite
CNOSSEN, M. H., AARSEN, F. K., AKKER, S. L. V. D., DANEN, R., APPEL, I. M., STEYERBERG, E. W. and CATSMAN-BERREVOETS, C. E. (2010), Paediatric arterial ischaemic stroke: functional outcome and risk factors. Developmental Medicine & Child Neurology, 52: 394–399. doi: 10.1111/j.1469-8749.2009.03580.x
- Issue online: 4 MAR 2010
- Version of Record online: 18 JAN 2010
- PUBLICATION DATA Accepted for publication 30th October 2009. Published online 18th January 2010.
Aim To study functional outcome in children aged 1 month to 18 years after paediatric arterial ischaemic stroke (PAIS) and to identify risk factors influencing their quality of life.
Method In a consecutive series of 76 children (35 males 41 females, median age at diagnosis 2y 6mo, range 1mo–17y 2mo; median length of follow-up 2y 4mo, range [7mo–10y 6mo]) with PAIS diagnosed at the Erasmus Medical Centre Sophia Children's Hospital between 1997 and 2006, we collected clinical, biochemical, and radiological data prospectively. In 66 children surviving at least 1 year after PAIS, functional outcome could be evaluated with the World Health Organization’s International Classification of Impairments, Disabilities and Handicaps.
Results Significant risk factors at presentation for a poor neurological outcome were young age, infarction in the right middle cerebral artery territory, and fever at presentation. Fifty-four % of children had severe neurological impairments at 12 months after PAIS, and at last follow-up more than half needed remedial teaching, special education, or institutionalization. Health-related quality of life (HRQOL) questionnaires showed a significantly lower HRQOL in all age groups. Children with a longer follow-up had a lower HRQOL in the cognitive functioning domain.
Interpretation Our study shows significant morbidity and mortality and a reduced HRQOL after PAIS depending on age, fever at presentation, and infarction in the right middle cerebral artery territory.