Long-term motor, functional, and academic outcome following childhood ischemic and hemorrhagic stroke: A large rehabilitation center-based retrospective study

Yvon, Estelle; Lamotte, D.; Tiberghien, Anne; Godard, Ingrid; Mardaye, Alain; Laurent-Vannier, A.; Agostini, Maria De; Chevignard, Mathilde

doi:10.1080/17518423.2016.1247923

Cited by 21 publications

(13 citation statements)

References 35 publications

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“…As in previous studies, the analysis of these routinely collected clinical data demonstrate a heterogeneity, even within this more severe group. Overall, we present a reduction in the complexity of care needs and an increase in functional independence, which concurs with previous findings (Galvin et al., 2011; Yvon et al., 2018). While analysis of the data has shown that those with a hemispheric stroke had a higher level of independence than those with a global stroke, the numbers in these subgroups are small and further collaborative research is necessary across rehabilitation centres using commonly agreed measures to understand more about the outcomes in this group.…”

Section: Discussionsupporting

confidence: 93%

“…It is estimated that of the children who survive a stroke, half will face long-term neurological disability and functional limitations (Mackay and Steinlin, 2019). As a result, full participation in everyday social, educational and family life may be severely compromised, with the effects becoming more apparent over time (Ganesan, 2013; Greenham et al., 2018; McKevitt et al., 2019; Shepherd, 2012; Yvon et al., 2018).…”

Section: Literature Reviewmentioning

confidence: 99%

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Following severe childhood stroke, specialised residential rehabilitation improves self-care independence but there are ongoing needs at discharge

Wales¹,

Dunford

Davis³

2020

British Journal of Occupational Therapy

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Introduction Stroke is a major cause of mortality and disability in childhood. There is a false belief that children will recover better than adults and recent research confirms that younger age at injury can have a negative impact on rehabilitation outcomes, resulting in lifelong disability. Self-care is a key rehabilitation outcome for children and young people. Methods This service evaluation reviews routinely collected clinical self-care data from one specialised residential rehabilitation centre in the United Kingdom. Admission and discharge scores from the United Kingdom Functional Independence Measure +Functional Assessment Measure, Rehabilitation Complexity Scale – E and Northwick Park Nursing Dependency Scale were analysed. Results Twenty-six children and young people age 8 years and over with severe stroke were included. Mean scores of independence increased and mean scores of complexity and dependency decreased. A proportion of the sample had ongoing self-care needs in relation to support needed in washing, dressing and bathing. A small number remained highly dependent, requiring assistance from two carers. Conclusion Children and young people make significant gains in self-care independence during specialised rehabilitation. However, a proportion return to the community with high self-care needs. Occupational therapists and the wider care team should address ongoing self-care needs in this population.

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Section: Discussionsupporting

confidence: 93%

Section: Literature Reviewmentioning

confidence: 99%

Following severe childhood stroke, specialised residential rehabilitation improves self-care independence but there are ongoing needs at discharge

Wales¹,

Dunford

Davis³

2020

British Journal of Occupational Therapy

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“…419 In a longer-term study of 82 children with hemorrhagic stroke at a median follow-up of 43 months, 40% were receiving special education. 420…”

Section: Discussionmentioning

confidence: 99%

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Ferriero¹,

Fullerton²,

Bernard³

et al. 2019

Stroke

530

515

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Purpose-Much has transpired since the last scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee and were chosen to reflect the expertise of the subject matter. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. This scientific statement is based on expert consensus considerations for clinical practice. Results-Annualized pediatric stroke incidence rates, including both neonatal and later childhood stroke and both ischemic and hemorrhagic stroke, range from 3 to 25 per 100 000 children in developed countries. Newborns have the highest risk ratio: 1 in 4000 live births. Stroke is a clinical syndrome. Delays in diagnosis are common in both perinatal and childhood stroke but for different reasons. To develop new strategies for prevention and treatment, disease processes and risk factors that lead to pediatric stroke are discussed here to aid the clinician in rapid diagnosis and treatment. The many important differences that affect the pathophysiology and treatment of childhood stroke are discussed in each section. Conclusions-Here we provide updates on perinatal and childhood stroke with a focus on the subtypes, including arterial ischemic, venous thrombotic, and hemorrhagic stroke, and updates in regard to areas of childhood stroke that have not received close attention such as sickle cell disease. Each section is highlighted with considerations for clinical practice, attendant controversies, and knowledge gaps. This statement provides the practicing provider with much-needed updated information in this field. (Stroke. 2019;50:e00-e00.

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“…Recently, a rehabilitation centre-based retrospective study focused on the long-term outcome of 128 children after childhood AIS and HS. In general, they saw better motor neurological, functional and academic outcomes after HS (vs AIS) at time of discharge from the rehabilitation department 26. However, at time of discharge (median time since the stroke of 4.7 months), 59.3% of children with HS showed some degree of motor deficit and 35.8% required special education after a median follow-up period of 43 months.…”

Section: Discussionmentioning

confidence: 90%

Childhood haemorrhagic stroke: a 7-year single-centre experience

Gerstl¹,

Badura²,

Heinen³

et al. 2019

Arch Dis Child

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BackgroundIn recent years, there has been increasing research interest in improving diagnostic and management protocols in childhood arterial ischaemic stroke (AIS). However, childhood stroke comprises, in approximately equal parts, both arterial ischaemic and haemorrhagic stroke (HS).ObjectiveThe aim of this study was to focus on the aetiology, clinical presentation, treatment and short-term outcome of children with spontaneous intracranial bleeding in a university hospital and elucidate differences to childhood AIS.DesignWe performed a retrospective analysis of electronic medical records of children (28 days–18 years) diagnosed with HS between 2010 and 2016.ResultsWe included 25 children (male child, n=11) with a median age of 8 years 1 month. The most common clinical presentations were vomiting (48%), headache (40%) and altered level of consciousness (32%). In more than half of the patients, HS was caused by vascular malformations. Other risk factors were brain tumour, coagulopathy and miscellaneous severe underlying diseases. Aetiology remained unclear in one child. Therapy was neurosurgical in most children (68%). Two patients died, 5 patients needed further (rehabilitation) treatment and 18 children could be discharged home.ConclusionsHS differs from AIS in aetiology (vascular malformations as number one risk factor), number of risk factors (‘mono-risk’ disease), clinical presentation (vomiting, headache and altered level of consciousness) and (emergency) therapy.

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Long-term motor, functional, and academic outcome following childhood ischemic and hemorrhagic stroke: A large rehabilitation center-based retrospective study

Abstract: Childhood stroke leads to severe and long lasting motor, functional, cognitive, and academic impairments, in a population of children admitted in a rehabilitation department.

Cited by 21 publications

References 35 publications

Following severe childhood stroke, specialised residential rehabilitation improves self-care independence but there are ongoing needs at discharge

Following severe childhood stroke, specialised residential rehabilitation improves self-care independence but there are ongoing needs at discharge

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

Childhood haemorrhagic stroke: a 7-year single-centre experience

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