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Updated: Mar 24, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Outcome and recurrence 1 year after pediatric arterial ischemic stroke in a population-based cohort
Andrew A Mallick1, Vijeya Ganesan2, Fenella J Kirkham2,3
1Department of Paediatric Neurology, Bristol Royal Hospital for Children, Bristol.
Insights
Childhood arterial ischemic stroke (AIS) carries risks, but a UK study found lower mortality and neurological deficits than previously reported. Outcomes at 12 months showed 50% good recovery, with seizures at onset predicting poor outcomes.
Area of Science:
- Pediatric neurology
- Neuroscience
- Public health
Background:
- Childhood arterial ischemic stroke (AIS) is a significant cause of acquired brain injury.
- Prospective, population-based studies on childhood AIS outcomes are limited.
- Understanding long-term neurological deficits is crucial for pediatric stroke management.
Purpose of the Study:
- To investigate the 12-month outcomes of childhood AIS in a population-based cohort.
- To assess mortality, recurrence rates, and neurological impairment following pediatric AIS.
- To compare findings with previously published United Kingdom data.
Main Methods:
- A prospective, population-based cohort study in southern England included children aged 29 days to 16 years with radiologically confirmed AIS.
- Outcomes were assessed at 12 months using the Pediatric Stroke Outcome Measure (PSOM) via home visits or interviews.
- Parental impressions of recovery and recurrence were collected using the Pediatric Stroke Recurrence and Recovery Questionnaire.
Main Results:
- Ninety-six children with AIS were identified; 90% survived to 12-month follow-up.
- Fifty percent of children achieved a good outcome (PSOM score < 1), while 50% had a poor outcome.
- Seizures at AIS onset were associated with a significantly higher risk of poor outcome (OR=3.5).
Conclusions:
- Childhood AIS presents a substantial risk of mortality and long-term neurological deficits.
- This study observed lower rates of mortality, recurrence, and neurological impairment compared to prior UK studies.
- Early identification and management of risk factors, such as seizures, are important for improving pediatric AIS outcomes.
Objective:
Arterial ischemic stroke (AIS) is an important cause of acquired brain injury in children. Few prospective population-based studies of childhood AIS have been completed. We aimed to investigate the outcome of childhood AIS 12 months after the event in a population-based cohort.
Methods:
Children aged 29 days to < 16 years with radiologically confirmed AIS occurring over a 1-year period residing in southern England (population = 5.99 million children) were eligible for inclusion. Outcome was assessed during a home visit using the Pediatric Stroke Outcome Measure (PSOM). Parental impressions of recovery were assessed using the Pediatric Stroke Recurrence and Recovery Questionnaire. PSOM score was estimated via telephone interview or clinician interview whenever home visit was not possible.
Results:
Ninety-six children with AIS were identified. Two children were lost to follow-up. Nine of 94 (10%) children died before the 12-month follow-up. One child had an AIS recurrence. PSOM scores were available for 78 of 85 living children at follow-up. Thirty-nine of 78 (50%) had a good outcome (total PSOM score < 1), and 39 of 78 (50%) had a poor outcome. Seizures at onset of AIS were associated with a poor outcome (odds ratio = 3.5, 95% confidence interval = 1.16-10.6). Twenty-eight of 73 (38%) children were judged by their carers to have fully recovered. Ten of 84 (12%) children had recurrent seizures, and 17 of 84 (20%) reported recurrent headaches.
Interpretation:
AIS carries a significant risk of mortality and long-term neurological deficit. However, the rates of mortality, recurrence, and neurological impairment were markedly lower in this study than previously published figures in the United Kingdom. Ann Neurol 2016;79:784-793.
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