Outcome and recurrence 1 year after paediatric arterial ischaemic stroke in a population-based cohort

Andrew A Mallick; Vijeya Ganesan; Fenella J Kirkham; Penny Fallon; Tammy Hedderly; Tony McShane; Alasdair P Parker; Evangeline Wassmer; Elizabeth Wraige; Sam Amin; Hannah B Edwards; Mario Cortina-Borja; Finbar J O'Callaghan

doi:10.1002/ana.24626

Outcome and recurrence 1 year after paediatric arterial ischaemic stroke in a population-based cohort

Andrew A Mallick, Vijeya Ganesan, Fenella J Kirkham, Penny Fallon, Tammy Hedderly, Tony McShane, Alasdair P Parker, Evangeline Wassmer, Elizabeth Wraige, Sam Amin, Hannah B Edwards, Mario Cortina-Borja, Finbar J O'Callaghan

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Abstract

OBJECTIVE: Arterial ischaemic 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 less than 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 Paediatric Stroke Outcome Measure (PSOM). Parental impressions of recovery were assessed using the Paediatric Stroke Recurrence and Recovery Questionnaire (RRQ). PSOM score was estimated via telephone interview or clinician interview whenever home-visit was not possible.

RESULTS: 96 children with AIS were identified. 2 children were lost to follow-up. 9/94 (10%) of 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. 39/78 (50%) had a good outcome (total PSOM score <1) and 39/78 (50%) had a poor outcome. Seizures at onset of AIS were associated with a poor outcome (Odds Ratio 3.5 95% CI 1.16-10.6). 28/73 (38%) children were judged by their carers to have fully recovered. 10/84 (12%) of children had recurrent seizures and 17/84 (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 UK. This article is protected by copyright. All rights reserved.

Original language	English
Pages (from-to)	784-793
Number of pages	10
Journal	Annals of Neurology
Volume	79
Issue number	5
Early online date	5 Apr 2016
DOIs	https://doi.org/10.1002/ana.24626
Publication status	Published - 6 May 2016

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Mallick, A. A., Ganesan, V., Kirkham, F. J., Fallon, P., Hedderly, T., McShane, T., Parker, A. P., Wassmer, E., Wraige, E., Amin, S., Edwards, H. B., Cortina-Borja, M., & O'Callaghan, F. J. (2016). Outcome and recurrence 1 year after paediatric arterial ischaemic stroke in a population-based cohort. Annals of Neurology, 79(5), 784-793. https://doi.org/10.1002/ana.24626

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title = "Outcome and recurrence 1 year after paediatric arterial ischaemic stroke in a population-based cohort",

abstract = "OBJECTIVE: Arterial ischaemic 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 less than 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 Paediatric Stroke Outcome Measure (PSOM). Parental impressions of recovery were assessed using the Paediatric Stroke Recurrence and Recovery Questionnaire (RRQ). PSOM score was estimated via telephone interview or clinician interview whenever home-visit was not possible.RESULTS: 96 children with AIS were identified. 2 children were lost to follow-up. 9/94 (10%) of 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. 39/78 (50%) had a good outcome (total PSOM score <1) and 39/78 (50%) had a poor outcome. Seizures at onset of AIS were associated with a poor outcome (Odds Ratio 3.5 95% CI 1.16-10.6). 28/73 (38%) children were judged by their carers to have fully recovered. 10/84 (12%) of children had recurrent seizures and 17/84 (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 UK. This article is protected by copyright. All rights reserved.",

author = "Mallick, {Andrew A} and Vijeya Ganesan and Kirkham, {Fenella J} and Penny Fallon and Tammy Hedderly and Tony McShane and Parker, {Alasdair P} and Evangeline Wassmer and Elizabeth Wraige and Sam Amin and Edwards, {Hannah B} and Mario Cortina-Borja and O'Callaghan, {Finbar J}",

year = "2016",

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doi = "10.1002/ana.24626",

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TY - JOUR

T1 - Outcome and recurrence 1 year after paediatric arterial ischaemic stroke in a population-based cohort

AU - Mallick, Andrew A

AU - Ganesan, Vijeya

AU - Kirkham, Fenella J

AU - Fallon, Penny

AU - Hedderly, Tammy

AU - McShane, Tony

AU - Parker, Alasdair P

AU - Wassmer, Evangeline

AU - Wraige, Elizabeth

AU - Amin, Sam

AU - Edwards, Hannah B

AU - Cortina-Borja, Mario

AU - O'Callaghan, Finbar J

PY - 2016/5/6

Y1 - 2016/5/6

N2 - OBJECTIVE: Arterial ischaemic 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 less than 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 Paediatric Stroke Outcome Measure (PSOM). Parental impressions of recovery were assessed using the Paediatric Stroke Recurrence and Recovery Questionnaire (RRQ). PSOM score was estimated via telephone interview or clinician interview whenever home-visit was not possible.RESULTS: 96 children with AIS were identified. 2 children were lost to follow-up. 9/94 (10%) of 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. 39/78 (50%) had a good outcome (total PSOM score <1) and 39/78 (50%) had a poor outcome. Seizures at onset of AIS were associated with a poor outcome (Odds Ratio 3.5 95% CI 1.16-10.6). 28/73 (38%) children were judged by their carers to have fully recovered. 10/84 (12%) of children had recurrent seizures and 17/84 (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 UK. This article is protected by copyright. All rights reserved.

AB - OBJECTIVE: Arterial ischaemic 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 less than 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 Paediatric Stroke Outcome Measure (PSOM). Parental impressions of recovery were assessed using the Paediatric Stroke Recurrence and Recovery Questionnaire (RRQ). PSOM score was estimated via telephone interview or clinician interview whenever home-visit was not possible.RESULTS: 96 children with AIS were identified. 2 children were lost to follow-up. 9/94 (10%) of 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. 39/78 (50%) had a good outcome (total PSOM score <1) and 39/78 (50%) had a poor outcome. Seizures at onset of AIS were associated with a poor outcome (Odds Ratio 3.5 95% CI 1.16-10.6). 28/73 (38%) children were judged by their carers to have fully recovered. 10/84 (12%) of children had recurrent seizures and 17/84 (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 UK. This article is protected by copyright. All rights reserved.

U2 - 10.1002/ana.24626

DO - 10.1002/ana.24626

M3 - Article (Academic Journal)

C2 - 26928665

SN - 0364-5134

VL - 79

SP - 784

EP - 793

JO - Annals of Neurology

JF - Annals of Neurology

IS - 5

ER -

Outcome and recurrence 1 year after paediatric arterial ischaemic stroke in a population-based cohort

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