Neuropediatrics 2010; 41 - V1255
DOI: 10.1055/s-0030-1265517

Differences in risk-factors, aetiology and outcome between children and young adults with acute ischaemic stroke

S Bigi 1, U Fischer 2, E Wehrli 4, HP Mattle 2, E Boltshauser 4, S Bürki 4, PY Jeannet 4, J Fluss 4, K Nedeltchev 2, M El-Koussy 3, M Steinlin 1 M Arnold 2, The first and last two authors contributed equally to this work
  • 1Department of Neuropaediatrics, Inselspital, University Hospital Bern and University of Bern, Switzerland
  • 2Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Switzerland
  • 3Department of Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Switzerland
  • 4The Swiss Neuropaediatric Stroke Registry

Objectives: Comparisons between children and young adults with acute ischaemic stroke are limited.

Methods: We compared baseline characteristics, stroke aetiology, stroke work-up and outcome (modified Rankin scale (mRS) at 3 to 6 months) in consecutive paediatric (age: 1 month –16.0 years) and young adult (age 16.1–45 years) patients with acute arterial ischaemic stroke. All paediatric stroke patients were collected prospectively in the Swiss Neuropaediatric Stroke registry, young adults in the Bernese stroke database.

Results: From January 2000 to December 2008 128 children (mean age 6.7 years) and 199 young adults (mean age 35.5y) suffered an acute ischaemic arterial stroke. Children were more likely to be male than young adults (61.7 versus 48.7%, p=0.023). Stroke severity on admission was similar in children and young adults (median NIHSS score 5.5 versus 6.0, p=0.131). Stroke subtype (Oxfordshire Community Stroke Project classification) did not differ significantly among children and young adults, however children tended more likely to have partial anterior circulation stroke (54% versus 45%) and less likely posterior circulation stroke (19% versus 32%). Stroke aetiology was more likely to be other determined cause in children than in young adults (48% versus 29%; p<0.001). Cervicocerebral artery dissections were more frequent in young adults than in children (23% vs. 10%; p=0.005). Outcome (disability and mortality) at 3 to 6 months did not differ significantly between both groups.

Conclusions: Even though stroke aetiology in children and young adults is different, baseline stroke severity and clinical outcome at 3–6 months after acute ischaemic arterial stroke was similar.