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Early prognostic indicators of outcome in ischemic childhood stroke
B J Delsing1, C E Catsman-Berrevoets, I M Appel
1Department of Child Neurology, University Hospital Rotterdam/Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Identifying early prognostic factors in pediatric ischemic arterial stroke is crucial. Altered consciousness, seizures, and middle cerebral artery strokes predict poor outcomes in children.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Vascular Neurology
Background:
- Childhood ischemic arterial stroke is a significant cause of long-term disability.
- Early identification of prognostic factors is essential for timely intervention and management.
- Understanding risk factors can improve clinical outcomes for affected children.
Purpose of the Study:
- To identify early prognostic indicators in pediatric ischemic arterial stroke.
- To correlate presenting symptoms, neuroimaging findings, and etiology with clinical outcomes.
- To establish predictors of poor prognosis in children diagnosed with ischemic stroke.
Main Methods:
- Retrospective analysis of 31 children with ischemic arterial stroke.
- Comparison of presenting symptoms (altered consciousness, seizures) with clinical outcomes.
- Evaluation of neuroimaging (MRI, CT) patterns, including middle cerebral artery involvement.
- Assessment of etiologic factors, age, and gender in relation to prognosis.
Main Results:
- Altered level of consciousness and seizures were significant risk factors for poor outcomes.
- Completed strokes or cortical involvement of the middle cerebral artery predicted adverse prognoses.
- Etiology, age at presentation, and gender did not show a significant correlation with prognosis.
Conclusions:
- Early clinical presentation (altered consciousness, seizures) and specific neuroimaging findings (MCA stroke) are key predictors of poor outcomes in pediatric ischemic stroke.
- These factors can guide clinical management and prognostication in affected children.
- Further research may explore the underlying mechanisms linking these factors to stroke severity.
Abstract:
The aim of this study was to identify early prognostic factors in children with ischemic arterial stroke. Presenting symptoms, patterns of infarction on magnetic resonance imaging and computed tomography scans, and etiologic findings were compared with clinical outcome in a consecutive series of 31 children with ischemic arterial stroke. Presentation with an altered level of consciousness, seizures, or both and a completed or cortical completed stroke of the middle cerebral artery were found to be significant risk factors for poor outcome. No significant correlation was found between prognosis of childhood stroke and etiology, age at presentation, or gender.