Neurological outcome after arterial ischemic stroke in children


1 Department of Pediatric Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Pediatric Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Stroke is an important cause of disability in children. Pediatric stroke may be due to significant permanent cognitive and motor handicap in children. In this study, we evaluated long-term outcomes of stroke in pediatric patients who have been discharged with definite diagnosis of stroke in Tehran Mofid children’s Hospital and Imam Hossein children’s Hospital located in Isfahan, Iran, from 2005 to 2012.
Materials and Methods: A total of 53 children with stroke were included in the study. Stroke outcomes as motor disability, seizures, and cognitive dysfunctions were assessed.

Results: After a median follow-up of 4 years, 15 (29%) patients experienced full recovery. Thirty-eight (71%) patients had some degree of neurological handicap.

Conclusion: Approximately 70% of children with arterial ischemic stroke suffer from long-term neurological disabilities including motor deficits, cognitive impairment, and late seizures. Stroke recurrence is the most important risk factor responsible for severe adverse neurological outcomes in pediatric stroke.


Deng Y, Wang Y, Yang W, Yu Y, Xu J, Wang Y, et al. Risk factors and imaging characteristics of childhood stroke in China. J Child Neurol 2015;30:339-43.  Back to cited text no. 1
Mallick AA, Ganesan V, Kirkham FJ, Fallon P, Hedderly T, McShane T, et al. Childhood arterial ischaemic stroke incidence, presenting features, and risk factors: A prospective population-based study. Lancet Neurol 2014;13:35-43.  Back to cited text no. 2
Giroud M, Lemesle M, Gouyon JB, Nivelon JL, Milan C, Dumas R. Cerebrovascular disease in children under 16 years of age in the city of Dijon, France: A study of incidence and clinical features from 1985 to 1993. J Clin Epidemiol 1995;48:1343-8.  Back to cited text no. 3
Gomes A, Rinehart N, Greenham M, Anderson V. A critical review of psychosocial outcomes following childhood stroke (1995-2012). Dev Neuropsychol 2014;39:9-24.  Back to cited text no. 4
Elbers J, deVeber G, Pontigon AM, Moharir M. Long-term outcomes of pediatric ischemic stroke in adulthood. J Child Neurol 2014;29:782-8.  Back to cited text no. 5
Lee EH, Yum MS, Ko TS. Risk factors and clinical outcomes of childhood ischemic stroke in a single Korean tertiary care center. J Child Neurol 2012;27:485-91.  Back to cited text no. 6
Lo W, Gordon AL, Hajek C, Gomes A, Greenham M, Anderson V, et al. Pediatric stroke outcome measure: Predictor of multiple impairments in childhood stroke. J Child Neurol 2014;29:1524-30.  Back to cited text no. 7
Mallick AA, O'Callaghan FJ. Risk factors and treatment outcomes of childhood stroke. Expert Rev Neurother 2010;10:1331-46.  Back to cited text no. 8
Hajek CA, Yeates KO, Anderson V, Mackay M, Greenham M, Gomes A, et al. Cognitive outcomes following arterial ischemic stroke in infants and children. J Child Neurol 2014;29:887-94.  Back to cited text no. 9
Fox CK, Glass HC, Sidney S, Lowenstein DH, Fullerton HJ. Acute seizures predict epilepsy after childhood stroke. Ann Neurol 2013;74:249-56.  Back to cited text no. 10
Abend NS, Beslow LA, Smith SE, Kessler SK, Vossough A, Mason S, et al. Seizures as a presenting symptom of acute arterial ischemic stroke in childhood. J Pediatr 2011;159:479-83.  Back to cited text no. 11
Chadehumbe MA, Khatri P, Khoury JC, Alwell K, Szaflarski JP, Broderick JP, et al. Seizures are common in the acute setting of childhood stroke: A population-based study. J Child Neurol 2009;24:9-12.  Back to cited text no. 12
Sträter R, Becker S, von Eckardstein A, Heinecke A, Gutsche S, Junker R, et al. Prospective assessment of risk factors for recurrent stroke during childhood – A 5-year follow-up study. Lancet 2002;360:1540-5.  Back to cited text no. 13
Rodan L, McCrindle BW, Manlhiot C, MacGregor DL, Askalan R, Moharir M, et al. Stroke recurrence in children with congenital heart disease. Ann Neurol 2012;72:103-11.  Back to cited text no. 14
Per H, Unal E, Poyrazoglu HG, Ozdemir MA, Donmez H, Gumus H, et al. Childhood stroke: Results of 130 children from a reference center in Central Anatolia, Turkey. Pediatr Neurol 2014;50:595-600.  Back to cited text no. 15
Pavlovic J, Kaufmann F, Boltshauser E, Capone Mori A, Gubser Mercati D, Haenggeli CE, et al. Neuropsychological problems after paediatric stroke: Two year follow-up of Swiss children. Neuropediatrics 2006;37:13-9.  Back to cited text no. 16
deVeber GA, MacGregor D, Curtis R, Mayank S. Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis. J Child Neurol 2000;15:316-24.  Back to cited text no. 17
Emam AT, Ali AM, Babikr MA. Childhood stroke in Eastern Province, KSA: Pattern, risk factors, diagnosis and outcome. Acta Paediatr 2009;98:1613-9.  Back to cited text no. 18
Salih MA, Abdel-Gader AG, Al-Jarallah AA, Kentab AY, Al-Nasser MN. Outcome of stroke in Saudi children. Saudi Med J 2006;27 Suppl 1:S91-6.  Back to cited text no. 19
Naess H, Waje-Andreassen U, Thomassen L, Nyland H, Myhr KM. Do all young ischemic stroke patients need Long-term secondary preventive medication? Neurology 2005;65:609-11.  Back to cited text no. 20