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Childhood strokes in China describing clinical characteristics, risk factors and performance indicators: a
Yaxian Deng1, Gaifen Liu2, Guitao Zhang3
1Department of Pediatrics, Beijing Tiantan Hosppital Affiliated to Capital Medical University, Beijing, China dengyx77@163.com.
Insights
Cerebral arteriopathy is a key risk factor for childhood stroke in China. Further research is needed to identify more risk factors and improve interventions for pediatric stroke.
Area of Science:
- Neurology
- Pediatrics
- Epidemiology
Background:
- Childhood stroke is a significant health concern with varying clinical characteristics and risk factors globally.
- Understanding these factors in specific populations, such as in China, is crucial for effective prevention and treatment.
Purpose of the Study:
- To investigate the clinical characteristics, risk factors, neurologic deficits, and medical care provided to children experiencing stroke in China.
Main Methods:
- A retrospective case-series study was conducted using medical records of children (1 month to 18 years) admitted with arterial ischemic stroke (AIS) or hemorrhagic stroke (HS) in Beijing between January 2018 and December 2018.
- Data collected included demographics, clinical presentations, risk factors, laboratory results, neuroimaging, and neurological sequelae.
Main Results:
- 312 first stroke admissions were identified (172 AIS, 140 HS). Cerebral arteriopathy, including moyamoya disease for AIS and arteriovenous malformations for HS, were leading causes.
- Hemiplegia was the most common presentation for AIS, while headache was most common for HS. Neurological deficits were prevalent (62.8% AIS, 72.86% HS).
- Healthcare utilization for acute treatment and secondary prevention varied and was lower for AIS patients. Common complications included epilepsy and pneumonia (AIS) and epilepsy and hydrocephalus (HS).
Conclusions:
- Cerebral arteriopathy is a major risk factor for both AIS and HS in children in China.
- Larger epidemiological studies are necessary to identify further risk factors and develop effective preventive strategies and interventions for pediatric stroke.
Aim:
To investigate clinical characteristics, risk factors (RFs), neurologic deficits and medical care provided in children who had a stroke in China.
Methods:
We conducted a retrospective case-series study using the medical records of children aged 1 month to 18 years with arterial ischaemic stroke (AIS) or haemorrhagic stroke (HS) (with the entry codes I60, I61, I62, I63 (ICD-10)), who were admitted to different hospitals in Beijing, between January 2018 and December 2018. We obtained the following information from the charts: demographic characteristics, clinical presentations, RFs for paediatric stroke, laboratory examination, neuroimaging records and neurologic sequelae.
Results:
We identified 312 first admissions for stroke (172 AIS and 140 HS). The mean age at onset was 8.6±3.9 years for patients who had an AIS and 8 (5-13) years for patients who had an HS. There were more males than females in both groups (AIS: 59.88% vs 40.12%; HS: 52.14% vs 47.86%). A known aetiology was identified in 92.44% and 86.43% of patients who had an AIS and HS, respectively. The leading cause of AIS was cerebrovascular diseases including moyamoya (68.6%), while that for HS was arteriovenous malformation (51.43%). The most common initial clinical presentation was hemiplegia (86.05%) in patients who had an AIS and headache (67.86%) in patients who had an HS. The use of healthcare, including acute treatment (antithrombotic in 17.44%, anticoagulant in 5.23%) and secondary prevention (antithrombotic in 6.39%, anticoagulant in 1.16%), varied and was significantly lower among patients who had an AIS. The most common complications were epilepsy (22.09%) and pneumonia (4.65%) in patients who had an AIS and epilepsy (17.14%) and hydrocephalus (12.14%) in patients who had an HS. Neurological deficits occurred in 62.8% of patients who had an AIS and 72.86% of patients who had an HS.
Conclusion:
Cerebral arteriopathy was a major RF for both AIS and HS in children living in China. Large epidemiological studies are required to identify RFs to prevent stroke as well as appropriate interventions.
