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J Stroke Cerebrovasc Dis. 2017 Jul;26(7):1646-1652. doi: 10.1016/j.jstrokecerebrovasdis.2017.03.043. Epub 2017 May 2.

Prevalence and Predictors of Long-Term Functional Impairment, Epilepsy, Mortality, and Stroke Recurrence after Childhood Stroke: A Prospective Study of a Chilean Cohort.

Author information

1
Unit of Pediatric Neurology, Division of Pediatrics, School of Medicine, Pontifical University Catholic of Chile, Santiago, Chile. Electronic address: mlopeze@med.puc.cl.
2
Unit of Pediatric Neurology, Division of Pediatrics, School of Medicine, Pontifical University Catholic of Chile, Santiago, Chile. Electronic address: mhernand@med.puc.cl.

Abstract

BACKGROUND:

To evaluate the prevalence and predictors of long-term impairment, epilepsy, mortality, and recurrences after the first stroke in a cohort of Chilean children.

METHODS:

A prospective study involving 98 children who suffered a first stroke and underwent follow-up for at least 3 years in a single center. Functional outcome was measured using the modified Rankin Scale for children. We utilized multivariate logistic regression models to estimate the odds ratios (ORs) for outcomes while adjusting for age, sex, and underlying conditions (significance <.05).

RESULTS:

Stroke recurrences were present in 18 children and were strongly associated with arteriopathies (OR 8.11; CI 1.5-43). Of 26 children who died during the follow-up period, a significant proportion had a cardiopathy (OR 6.57; CI 1.3-32) or a chronic head and neck disease (OR 41.3; CI 3.5-490). Among 72 survivors (median age 1.49 years; 38 girls; mean follow-up time 4.85 years), 28 presented marked impairment; these children were younger (P = .019) and had more commonly arteriopathies (OR 9.33; CI 1.7-51) and epilepsy (OR 10.5; CI 3.1-36) as compared to survivors without disabilities. Cumulative epilepsy prevalence was 55.6%; children with epilepsy were younger (P = .037) and had more commonly acute symptomatic seizures (OR 12.16; CI 2.93-50.4) as compared to survivors without epilepsy.

CONCLUSIONS:

The prevalence of long-term adverse outcomes after childhood stroke is high and does not differ from other geographical and racial groups. Younger age, acute seizures, and arteriopathies but not sex and other underlying conditions predict adverse outcome following childhood stroke.

KEYWORDS:

Childhood stroke; epilepsy; functional outcome; long-term prognosis; mortality; neurological impairment; stroke recurrence

[Indexed for MEDLINE]

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