Acute ischemic stroke in children versus young adults
Sandra Bigi1, Urs Fischer, Edith Wehrli
1Department of Pediatric Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.
Annals of Neurology
|August 9, 2011
Summary
Children and young adults with acute ischemic stroke (AIS) have different risk factors and causes, but similar stroke severity and outcomes. This finding is crucial for understanding pediatric and young adult AIS.
Area of Science:
- Neurology
- Pediatric Neurology
- Stroke Medicine
Background:
- Acute ischemic stroke (AIS) affects both children and young adults, but distinct epidemiological and etiological profiles are suspected.
- Understanding these differences is vital for tailored diagnostic and therapeutic approaches.
Purpose of the Study:
- To compare clinical characteristics, stroke etiology, diagnostic workup, and outcomes of AIS in children (1 month-16 years) versus young adults (16.1-45 years).
Main Methods:
- Utilized data from two large registries: the Swiss NeuroPediatric Stroke Registry for children and the Bernese stroke database for young adults.
- Compared clinical data, stroke etiology (TOAST classification), and outcomes (modified Rankin Scale [mRS] at 3-6 months).
- Assessed stroke severity using the pediatric adaptation of the National Institutes of Health stroke scale (PedNIHSS) for children and NIHSS for young adults.
Main Results:
- 128 children and 199 young adults with AIS were analyzed.
- Children were more likely male and less likely to have hypertension, hypercholesterolemia, or a family history of stroke.
- Stroke etiology differed significantly, with "other determined cause" more frequent in children, while cervicocerebral artery dissections were less common.
- Stroke severity (PedNIHSS/NIHSS) and 3-6 month outcomes (mRS 0-1) were similar between groups (59% children, 60% young adults).
- Low stroke severity was the strongest predictor of favorable outcome in multivariate analysis.
Conclusions:
- Despite differing stroke etiologies and risk factors, children and young adults with AIS exhibit comparable stroke severity and clinical outcomes.
- These findings highlight the need for age-specific considerations in AIS management while underscoring universal predictors of good outcomes.
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