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Comparative Outcomes of Paediatric Stroke in Supratentorial and Infratentorial Regions: A 12-Year Hospital-Based
Azita Tavasoli1, Aina Riahi1, Mohammad Vafaee Shahi2
1Pediatric Neurology, Aliasghar Children Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Insights
Pediatric stroke location impacts outcomes. Supratentorial strokes in children are linked to worse motor and cognitive impairments compared to infratentorial strokes, affecting long-term recovery.
Area of Science:
- Neurology
- Pediatrics
- Clinical Outcomes
Background:
- Pediatric stroke presents diverse clinical features and prognoses based on brain region affected.
- Supratentorial and infratentorial strokes may lead to different clinical manifestations and outcomes.
- Understanding these differences is vital for tailored treatment strategies in pediatric stroke care.
Purpose of the Study:
- To compare the clinical outcomes of pediatric stroke patients with supratentorial versus infratentorial stroke locations.
- To identify potential differences in motor and cognitive impairments between stroke location groups in children.
- To inform targeted interventions and improve long-term management of pediatric stroke.
Main Methods:
- Retrospective cohort study of 100 pediatric stroke patients (under 18 years) hospitalized between 2011-2023.
- Assessment of motor and cognitive impairments at 24 months post-stroke using Modified Rankin Scale (MRS), Bayley-III, and Binet scales.
- Statistical analysis using T-tests and Chi-square tests to compare outcomes between supratentorial and infratentorial stroke groups.
Main Results:
- Supratentorial strokes occurred in 78% of pediatric cases.
- Children with supratentorial strokes showed significantly lower Bayley scores (cognitive) and higher MRS scores (motor impairment) compared to the infratentorial group.
- No significant difference in Binet scores or age/gender distribution was found between the groups.
Conclusions:
- Pediatric supratentorial strokes are associated with more severe long-term motor and cognitive impairments.
- Stroke location is a critical factor influencing long-term outcomes in pediatric stroke patients.
- Further research is warranted to explore long-term sequelae based on stroke topography in children.
Objectives:
The clinical outcomes of pediatric stroke in patients can vary significantly depending on the affected brain region. Supratentorial and infratentorial strokes may present different clinical features and prognoses. Understanding these differences is crucial for developing targeted treatment strategies and improving patient care. Accordingly, this study aimed to compare the outcomes of patients under 18 years old with supratentorial and infratentorial strokes.
Materials & Methods:
This retrospective cohort study included 100 children under 18 years old hospitalized due to stroke at Ali Asghar and Rasoul Akram hospitals from 2011 to 2023 and followed for 24 months. The motor and cognitive impairments were assessed 24 months post-stroke using the Modified Rankin Scale (MRS), the Bayley-III Scale (for children under three years), and the Binet scale (for children over three years). Statistical analyses were performed using T-tests and Chi-square tests. The required data include age, gender, stroke type (ischemic or hemorrhagic), stroke location (supratentorial /infratentorial), and underlying conditions.
Results:
The mean age of the patients was 70.47 months. About 57% of the patients were older than two years, and 67% were male. Supratentorial stroke was observed in 78% of cases. No significant difference was observed in age or gender distribution between the supratentorial and infratentorial groups (P = 0.64 and P = 0.128, respectively). Outcome comparisons between the groups revealed no significant difference in Binet scores; however, children with supratentorial strokes had significantly lower Bayley scores and higher MRS scores compared to the infratentorial group (P = 0.023 and P = 0.002, respectively).
Conclusion:
The present findings indicate that children with supratentorial strokes may experience more severe long-term motor and cognitive impairments. Further research is needed to investigate long-term outcomes in pediatric stroke patients based on stroke location.
