Could infarct location predict the long-term functional outcome in childhood arterial ischemic stroke? (original) (raw)
Arquivos de Neuro-Psiquiatria
Objective: To explore the influence of infarct location on long-term functional outcome following a first-ever arterial ischemic stroke (AIS) in non-neonate children. Method: The MRIs of 39 children with AIS (median age 5.38 years; 36% girls; mean follow-up time 5.87 years) were prospectively evaluated. Infarct location was classified as the absence or presence of subcortical involvement. Functional outcome was measured using the modified Rankin scale (mRS) for children after the follow-up assessment. We utilized multivariate logistic regression models to estimate the odds ratios (ORs) for the outcome while adjusting for age, sex, infarct size and middle cerebral artery territory involvement (significance < 0.05). Results: Both infarcts ≥ 4% of total brain volume (OR 9.92; CI 1.76 – 55.9; p 0.009) and the presence of subcortical involvement (OR 8.36; CI 1.76 – 53.6; p 0.025) independently increased the risk of marked functional impairment (mRS 3 to 5). Conclusion: Infarct extensi...
Related papers
Children, 2021
Arterial ischemic stroke (AIS) in children is a rare condition; its frequency is estimated at 0.58 to 7.9 new onsets in 100,000 children per year. The knowledge on risk factors, clinical outcomes and consequences of pediatric AIS is increasing. However, there are still many unknowns in the field. The aim of the study was to analyze the clinical presentation of pediatric AIS and its consequences according to the neuroimaging results and location of ischemia. The research was retrospective and observational. The analyzed group consisted of 75 AIS children (32 girls, 43 boys), whereby the age of the patients ranged from 9 months to 18 years at stroke onset. All the patients were diagnosed and treated in one tertiary center. The most frequent stroke subtype was total anterior circulation infarct (TACI) with most common ischemic focus location in temporal lobe and vascular pathology in middle cerebral artery (MCA). The location of ischemic focus in the brain correlated with post-stroke o...
Acute ischemic stroke: Relationship of brain lesion location & functional outcome
Disability and rehabilitation, 2009
Purpose. To establish, using brain spiral computerised tomography (SCT) and modified Barthel index (MBI), whether the location of cerebral infarction could be correlated with functional outcome in acute ischemic stroke patients who undergo early intensive rehabilitation. Methods. Observational cohort, assessor blinded and correlational prospective 12-weeks study that included 111 acute ischemic stroke patients, admitted consecutively to an early intensive inpatient rehabilitation programme (5 days a week, 3-5 h a day) during 2003. Confirmation of diagnosis and stratification was done by brain SCT. Brain lesion locations were correlated to motor performance and functional outcome, on admission and discharge, using MBI. Results. Statistical analysis demonstrated a significant correlation between motor performance, functional outcome and brain lesion locations. The groups with deep, combined deep and large superficial, small superficial and large superficial infarcts showed the most consistent improvement in that order of frequency. Normal brain SCT group did not reach statistical significance (p ¼ 0.051) while the bi-hemispheric infarcts group did not show any change. The inter and intra group differences were highly significant (p 5 0.05). Conclusions. Immediate non-contrasted brain SCT may act as an independent predictor of final functional outcome in acute ischemic stroke. It may provide clinicians with an opportunity to offer realistic expectations to stroke patients and their relatives.
2018
Objective was to study etiological factors, clinical features, neuroradiological findings, Outcome in infants and children who present with ischemic stroke.Study design: It was a descriptive study.Setting: It was a hospital based study which was conducted in the Children Hospital, Pakistan Institute of Medical Sciences from 1st August 2002 to 30th December 2003.Method: In this study children were included who presented with weakness, altered sensorium, seizures, or any focal deficit. CT brain was done in all these children. Those having evidence of infarct were studied for clinical features, etiological factors and out come. Those having neurological infection, trauma, brain tumor, and abscess were excluded from the study. For data analysis, SPSS 8 software was used.Results: Total of studied thirty patients were enrolled in the study. Age range was from two month to twelve years. Male to female ratio was 3.3 to 1. Sixteen (53%) were 6-12 years of age while 12 (40%) were 2-5 years ag...
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.