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Basilar artery stroke in childhood
Barbara Goeggel Simonetti1, Barbara Ritter, Matthias Gautschi
1Division of Paediatric Neurology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland. barbara.goeggel-simonetti@insel.ch
Developmental Medicine and Child Neurology
|November 21, 2012
Summary
Basilar artery stroke (BAS) in children is rare, with an incidence of 0.037 per 100,000 children annually. Despite diagnostic delays, outcomes are more favorable than in adults, especially with a lower PedNIHSS score.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Epidemiology
Background:
- Basilar artery stroke (BAS) is poorly understood in pediatric populations.
- This study aims to elucidate the characteristics and outcomes of childhood BAS.
Purpose of the Study:
- To determine the incidence of BAS in children.
- To analyze clinical presentation, risk factors, radiological findings, and treatment approaches.
- To evaluate outcomes and identify prognostic factors for childhood BAS.
Main Methods:
- A prospective, population-based study of pediatric arterial ischemic stroke cases.
- Systematic literature review to identify additional childhood BAS cases.
- Analysis of incidence, clinical features, etiology, treatment, and outcomes.
Main Results:
- The incidence of BAS in children was found to be 0.037 per 100,000 children per year.
- Common symptoms included impaired consciousness, hemiparesis/quadriparesis, and bulbar dysfunction.
- A significant proportion of cases had vasculopathic etiology or unknown causes, with a median Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score of 15.
- Good outcomes (modified Rankin Scale 0-2) were observed in 45 patients, while eight died. A PedNIHSS score of 17 or less was a prognostic factor for favorable outcomes.
Conclusions:
- Childhood BAS is a rare condition with a more favorable prognosis compared to adults.
- Delays in diagnosis and treatment are common but do not preclude better outcomes.
- Lower PedNIHSS scores (≤17) are associated with improved outcomes in pediatric BAS.
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