Ischaemic stroke subtypes in children and adults

Area of Science:

• Neurology
• Pediatric Neurology
• Stroke Research

Background:

• Ischaemic stroke affects both children and adults, but the underlying causes may differ.
• Understanding stroke aetiology is crucial for targeted treatment and prevention strategies.
• Current classification systems, like the Trial of Org 10172 in Acute Stroke Therapy (TOAST), are primarily based on adult data.

Purpose of the Study:

• To compare the aetiologies of ischaemic stroke in pediatric and adult populations.
• To determine the similarity and differences in stroke subtypes between children and adults.
• To assess the applicability of the modified TOAST classification system in pediatric stroke.

Main Methods:

• A retrospective analysis of 36 children and 50 adults diagnosed with ischaemic stroke between 1995 and 2000.
• Patients were categorized using a modified Trial of Org 10172 in Acute Stroke Therapy (TOAST) classification system.
• Statistical comparison (chi-squared test) of the proportions of patients across different TOAST subtypes between the two age groups.

Main Results:

• Significant differences (p<0.01) were observed in the distribution of ischaemic stroke subtypes between children and adults.
• The majority of adult strokes (54%) were attributed to large artery atherosclerosis, cardioembolism, or small vessel disease.
• In contrast, these three subtypes accounted for only 8% of pediatric strokes; most children (81%) fell into the 'other determined aetiology' category.
• Undetermined aetiology was more common in adults (24%) than in children (8%).

Conclusions:

• The aetiologies of ischaemic stroke in children and adults are distinct.
• The modified TOAST classification system reveals significant differences in stroke causes between pediatric and adult populations.
• Developing a specific classification system for pediatric ischaemic stroke is warranted to facilitate research and improve patient care.