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Long-Term Outcomes After Childhood Stroke

Kerttu Kivisikk1,2, Pilvi Ilves3,4, Mairi Männamaa2,3

  • 1Department of Pediatrics, Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia.

Pediatric Reports
|April 27, 2026
PubMed

Insights

Childhood stroke patients experienced poor long-term outcomes, with arterial hemorrhagic stroke (AHS) linked to higher mortality and worse neurodevelopmental issues than arterial ischemic stroke (AIS).

Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Neuroscience

Background:

  • Childhood stroke is a significant cause of long-term disability.
  • Understanding long-term outcomes based on vascular type is crucial for patient management.

Purpose of the Study:

  • To evaluate the long-term outcomes in children diagnosed with different vascular types of stroke.
  • To compare outcomes between arterial hemorrhagic stroke (AHS) and arterial ischemic stroke (AIS) in pediatric patients.

Main Methods:

  • Data from the Estonian Pediatric Stroke Database were analyzed for children aged 29 days to 18 years.
  • Outcomes including mortality, recurrent stroke, epilepsy, and neurodevelopmental status (using Pediatric Stroke Outcome Measure - PSOM) were assessed at least two years post-stroke.

Main Results:

  • Long-term outcomes were available for 44 patients; 75% experienced combined poor outcomes.
  • Patients with a Pediatric NIH Stroke Scale (PedNIHSS) score of ≥6 had worse outcomes.
  • Arterial hemorrhagic stroke (AHS) was associated with higher mortality, increased epilepsy risk, and poorer cognitive/behavioral outcomes compared to arterial ischemic stroke (AIS).

Conclusions:

  • Combined poor outcomes were prevalent in 75% of childhood stroke survivors.
  • Arterial hemorrhagic stroke (AHS) presents a higher risk of mortality and worse long-term neurodevelopmental outcomes compared to arterial ischemic stroke (AIS).

Keywords:
arterial ischemic strokecerebral venous sinus thrombosischildhood strokehemorrhagic strokeoutcome

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