The clinical outcomes of neonatal and childhood stroke: review of the literature and implications for future research

Abstract

A detailed assessment of clinical outcomes after ischemic stroke in childhood is necessary to evaluate prognostic factors. Previous studies are difficult to compare because of differences in test instruments, study design, heterogeneity of cohorts and number of included cases. Depending on neurodevelopmental assessment methods, major and subtle/minor disabilities, especially in infants, may not have been detected. Most outcome studies reveal only limited information about behavioral changes and quality of life in children with ischemic stroke. Thus the assumption that children make a better recovery from stroke than adults due to the immature brain's capacity to reorganize function is not evidence-based. We systematically review the current literature with regard to the neurological and psychosocial development of affected children as well as their quality of life. Implications for future research strategies follow the review to encourage further clinical study of the neurobehavioral trajectory of childhood stroke.

Psychosocial outcome and quality of life following childhood stroke – A systematic review

“…Stroke in childhood, defined as stroke between one month to eighteen years of age, has become increasingly recognised as a cause of childhood disability [2,3]. Reports of incidence rates range from 0.6 to 13 cases per 100.000 [4], with 1.6 to two cases per 100,000 children per year commonly reported [5,6]. Arterial Ischaemic Stroke (AIS) accounts for approximately half of all strokes in children in contrast to 80-85% of all strokes in adults [7].…”

The 5-year direct medical cost of neonatal and childhood stroke in a population-based cohort

“…[1][2][3][4][5][6][7][8] Historical impressions that children recover well from stroke have been contradicted by recent studies that document a high rate of lifelong morbidity.…”

The Cost of Pediatric Stroke Care and Rehabilitation

“…1,2 Interest in the causes of pediatric strokes has increased dramatically. [3][4][5][6] The need for rehabilitation and the growing number of diagnostic studies obviously contribute to the cost of care after a stroke; surprisingly, the costs of care after pediatric stroke have not been studied in detail.…”