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Acute ischemic stroke in children versus young adults


Bigi, S; Fischer, U; Wehrli, E; Mattle, H P; Boltshauser, E; Bürki, S; Jeannet, P Y; Fluss, J; Weber, P; Nedeltchev, K; El-Koussy, M; Steinlin, M; Arnold, M (2011). Acute ischemic stroke in children versus young adults. Annals of Neurology, 70(2):245-254.

Abstract

OBJECTIVE:

The aim of this study was to compare children and young adults with acute ischemic stroke (AIS) in 2 large registries.
METHODS:

We compared clinical characteristics, stroke etiology, workup, and outcome (modified Rankin scale score [mRS] at 3-6 months) in children (1 month-16 years) and young adults (16.1-45 years) with AIS. Data of children were collected prospectively in the nationwide Swiss NeuroPediatric Stroke Registry, young adults in the Bernese stroke database. Outcome (mRS) and stroke severity (pediatric adaptation of the National Institutes of Health stroke scale [PedNIHSS]) in children were calculated retrospectively.
RESULTS:

From January 2000 to December 2008, 128 children and 199 young adults suffered from an AIS. Children were more likely to be male than young adults (62%/49%, p = 0.023) and less frequently had hypertension (p = 0.001), hypercholesterolemia (p = 0.003), and a family history of stroke (p = 0.048). Stroke severity was similar in children and young adults (median PedNIHSS/NIHSS 5/6; p = 0.102). Stroke etiology (original TOAST classification) was more likely to be "other determined cause" in children than in young adults (51%/29%; p < .001). Cervicocerebral artery dissections were less frequent in children than in young adults (10%/23%; p = 0.005). Outcome at 3 to 6 months did not differ between children and young adults (p = 0.907); 59% of children and 60% of young adults had a favorable outcome (mRS 0-1). Mortality was similar among children and young adults (4%/6%; p = 0.436). In multivariate analysis, low PedNIHSS/NIHSS was the most important predictor of favorable outcome (p < 0.001).
INTERPRETATION:

Although stroke etiology and risk factors in children and young adults are different, stroke severity and clinical outcome were similar in both groups.

Copyright © 2011 American Neurological Association.

OBJECTIVE:

The aim of this study was to compare children and young adults with acute ischemic stroke (AIS) in 2 large registries.
METHODS:

We compared clinical characteristics, stroke etiology, workup, and outcome (modified Rankin scale score [mRS] at 3-6 months) in children (1 month-16 years) and young adults (16.1-45 years) with AIS. Data of children were collected prospectively in the nationwide Swiss NeuroPediatric Stroke Registry, young adults in the Bernese stroke database. Outcome (mRS) and stroke severity (pediatric adaptation of the National Institutes of Health stroke scale [PedNIHSS]) in children were calculated retrospectively.
RESULTS:

From January 2000 to December 2008, 128 children and 199 young adults suffered from an AIS. Children were more likely to be male than young adults (62%/49%, p = 0.023) and less frequently had hypertension (p = 0.001), hypercholesterolemia (p = 0.003), and a family history of stroke (p = 0.048). Stroke severity was similar in children and young adults (median PedNIHSS/NIHSS 5/6; p = 0.102). Stroke etiology (original TOAST classification) was more likely to be "other determined cause" in children than in young adults (51%/29%; p < .001). Cervicocerebral artery dissections were less frequent in children than in young adults (10%/23%; p = 0.005). Outcome at 3 to 6 months did not differ between children and young adults (p = 0.907); 59% of children and 60% of young adults had a favorable outcome (mRS 0-1). Mortality was similar among children and young adults (4%/6%; p = 0.436). In multivariate analysis, low PedNIHSS/NIHSS was the most important predictor of favorable outcome (p < 0.001).
INTERPRETATION:

Although stroke etiology and risk factors in children and young adults are different, stroke severity and clinical outcome were similar in both groups.

Copyright © 2011 American Neurological Association.

Citations

37 citations in Web of Science®
43 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:10 Feb 2012 19:46
Last Modified:05 Apr 2016 15:26
Publisher:Wiley-Liss
ISSN:0364-5134 (P) 1531-8249 (E)
Publisher DOI:https://doi.org/10.1002/ana.22427
PubMed ID:21823153
Permanent URL: https://doi.org/10.5167/uzh-56194

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