Prevalence and Predictors of Long-Term Functional Impairment, Epilepsy, Mortality, and Stroke Recurrence after Childhood Stroke: A Prospective Study of a Chilean Cohort

López-Espejo, Mauricio; Hernández‐Chávez, Marta

doi:10.1016/j.jstrokecerebrovasdis.2017.03.043

Cited by 17 publications

(16 citation statements)

References 38 publications

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“…The literature's data analyzing post-stroke consequences depending on sex in the group of pediatric patients are scarce. Most authors did not find any significant correlations [22,23,29]. In general, long-term neurologic consequences were observed in 31-70% of pediatric stroke patients [21][22][23][24][25][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

et al. 2020

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Arterial ischemic stroke (AIS) in childhood is reported to occur more frequently in boys, which may lead to the assumption that the prevalence of post-stroke deficits is sex related. The present study aimed to evaluate sex-related differences in functional outcomes (hemiparesis, seizures, aphasia, and motor disturbances other than hemiparesis) in pediatric patients with AIS. A total of 89 children (52 boys and 37 girls; mean age at stroke onset: 8.4 ± 5.6 years) were evaluated retrospectively based on data from medical records. The patients were divided into subgroups according to age (i.e., infants and toddlers, children, and adolescents), stroke subtype (i.e., lacunar anterior circulation infarct (LACI), total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI)) and stroke location (i.e., anterior stroke, posterior stroke). Significant differences in the prevalence of stroke subtypes between girls and boys were observed (p = 0.034). POCI stroke were found to be more frequent in boys than in girls (OR = 8.57 95%CI 1.05–70.23, p = 0.023). Males predominated in the total group and in all analyzed age subgroups. The proportions of boys within the subgroups according to stroke subtype were extremely high for the POCI and TACI stroke subgroups. On the other hand, girls predominated in the LACI stroke subgroup. Frequency of central type facial nerve palsy and other symptoms of AIS were found to significantly differ between male subgroups according to stroke subtype (p = 0.050 and p < 0.001, respectively), as well as between children with anterior stroke and those with posterior stroke (p = 0.059 and p < 0.001, respectively). Post-stroke seizures appeared significantly more commonly in girls with TACI and POCI stroke than in girls with LACI and PACI stroke (p = 0.022). In turn, the prevalence of post-stroke hemiparesis differed between stroke subtypes in boys (p = 0.026). In conclusion, sex may have an impact in predisposing to a certain type of AIS in the patient. Post-stroke seizure may be related to stroke subtype in girls and hemiparesis in boys. However, further studies are needed to confirm the results.

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Section: Discussionmentioning

confidence: 99%

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

et al. 2020

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“…13 Although not directly comparable because in-hospital mortality was not reported, our in-hospital mortality rate appears lower than the mortality Care withdrawn because of deficits (2) Congenital heart disease plus support withdrawn because of stroke-related deficits (2) Air leak syndrome related to congenital heart disease (1) Pneumothorax plus support withdrawn because of strokerelated deficits (2) Acute renal failure (1) Neurologic respiratory arrest plus severity of underlying disease (1) Meningitis (1) rate among Chilean children with AIS, among whom 26.5% died. 8 Geographic, sex, and racial disparities in childhood stroke mortality have been found in several studies. 1,5,7 In the Global Burden of Disease Study, there was excess mortality in children with ischemic stroke from developing nations compared with those from developed countries as well as a trend toward increased mortality in male patients.…”

Section: Figurementioning

confidence: 99%

“…4 The authors of most reports on mortality after pediatric AIS have not examined specific stroke risk factors or stroke severity; however, recent work from Chile revealed that cardiac disease and chronic head and/or neck conditions were associated with mortality. 8 We explored potential risk factors for mortality in a large multinational cohort of children and neonates with AIS.…”

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confidence: 99%

Mortality After Pediatric Arterial Ischemic Stroke

et al. 2018

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In-hospital mortality occurred in 2.6% of pediatric AIS cases. Most deaths were attributable to stroke. Risk factors for in-hospital mortality included congenital heart disease and posterior plus anterior circulation stroke. Presentation without seizures and Hispanic ethnicity were also associated with mortality for neonates and children, respectively. Awareness and study of risk factors for mortality represent opportunities to increase survival.

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“…313 Several studies have found that seizures during the acute poststroke period predict poor outcome. 303,314 Elbers et al 315 found that risk factors for abnormal functional outcome included presence of arteriopathy and 1-year poststroke Pediatric Stroke Outcome Measure score of 2 (P<0.05). Functional status at 1 year after stroke strongly predicts longterm outcome.…”

Section: Predictors Of Outcome After Childhood Strokementioning

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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Prevalence and Predictors of Long-Term Functional Impairment, Epilepsy, Mortality, and Stroke Recurrence after Childhood Stroke: A Prospective Study of a Chilean Cohort

Cited by 17 publications

References 38 publications

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

Does the Occurrence of Particular Symptoms and Outcomes of Arterial Ischemic Stroke Depend on Sex in Pediatric Patients?—A Pilot Study

Mortality After Pediatric Arterial Ischemic Stroke

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

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