Lucia Gerstl1, Raphael Weinberger2, Florian Heinen3, Michaela V Bonfert3, Ingo Borggraefe3, A Sebastian Schroeder3, Moritz Tacke3, Mirjam N Landgraf3, Katharina Vill3, Karin Kurnik4, Anna-Lisa Sorg2, Martin Olivieri4. 1. Department of Pediatric Neurology and Developmental Medicine, LMU Munich, University Hospital, Dr. von Hauner Children`s Hospital, Lindwurmstr. 4, 80337, Munich, Germany. lucia.gerstl@med.lmu.de. 2. Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, LMU Munich, Lindwurmstr. 4, 80337, Munich, Germany. 3. Department of Pediatric Neurology and Developmental Medicine, LMU Munich, University Hospital, Dr. von Hauner Children`s Hospital, Lindwurmstr. 4, 80337, Munich, Germany. 4. Department of Pediatric Hemostasis and Thrombosis, LMU Munich, University Hospital, Dr. von Hauner Children`s Hospital, Lindwurmstr. 4, 80337, Munich, Germany.
Abstract
OBJECTIVE: Childhood arterial ischaemic stroke (AIS) is rare, but causes significant morbidity and mortality. We aimed to investigate incidence, age-dependent clinical presentation, and risk factors and to discuss the medical care situation in Germany. METHODS: This prospective epidemiological study was conducted via ESPED (Erhebungseinheit für Seltene Pädiatrische Erkrankungen in Deutschland), a hospital-based German nation-wide surveillance unit for rare pediatric diseases. Children aged 28 days-18 years with first AIS between January 2015 and December 2017 were included. RESULTS: In the 3-year period, 164 children were reported. Incidence showed peaks in infants, children < 2 years of age, and adolescents (12-18 years), with a significant male predominance observed in adolescents only. Independent of age, most children (91%) presented with focal symptoms, particularly with acute hemiparesis. The occurrence of seizures in infants (57%) and more nonspecific symptoms in school-children and adolescents (54%) is considered noteworthy. Prothrombotic states (34%), cardiac disorders (29%), and arteriopathies (19%) were the most frequently identified risk factors. The majority of children (72/131, thus 55%) were discharged home after acute care phase. At time of discharge, most common neurological symptoms were hemiparesis (42%), facial palsy (15%), and speech disturbance (12%). CONCLUSION: This study provides population-based data of childhood AIS which may be useful for further research. The improvement of acute stroke management is needed for children, but also the standardization of post-stroke care in the outpatient setting has to be structured. Considering the higher stroke incidence in (male) adolescents, it is advisable to combine research activities in adolescents and young adults.
OBJECTIVE: Childhood arterial ischaemic stroke (AIS) is rare, but causes significant morbidity and mortality. We aimed to investigate incidence, age-dependent clinical presentation, and risk factors and to discuss the medical care situation in Germany. METHODS: This prospective epidemiological study was conducted via ESPED (Erhebungseinheit für Seltene Pädiatrische Erkrankungen in Deutschland), a hospital-based German nation-wide surveillance unit for rare pediatric diseases. Children aged 28 days-18 years with first AIS between January 2015 and December 2017 were included. RESULTS: In the 3-year period, 164 children were reported. Incidence showed peaks in infants, children < 2 years of age, and adolescents (12-18 years), with a significant male predominance observed in adolescents only. Independent of age, most children (91%) presented with focal symptoms, particularly with acute hemiparesis. The occurrence of seizures in infants (57%) and more nonspecific symptoms in school-children and adolescents (54%) is considered noteworthy. Prothrombotic states (34%), cardiac disorders (29%), and arteriopathies (19%) were the most frequently identified risk factors. The majority of children (72/131, thus 55%) were discharged home after acute care phase. At time of discharge, most common neurological symptoms were hemiparesis (42%), facial palsy (15%), and speech disturbance (12%). CONCLUSION: This study provides population-based data of childhood AIS which may be useful for further research. The improvement of acute stroke management is needed for children, but also the standardization of post-stroke care in the outpatient setting has to be structured. Considering the higher stroke incidence in (male) adolescents, it is advisable to combine research activities in adolescents and young adults.
Authors: Lucia Gerstl; M Olivieri; F Heinen; C Bidlingmaier; A S Schroeder; K Reiter; F Hoffmann; K Kurnik; T Liebig; C G Trumm; N A Haas; A Jakob; I Borggraefe Journal: Nervenarzt Date: 2022-01-24 Impact factor: 1.297
Authors: Katarina Svensson; Anna Walås; Jenny Bolk; Peter Bang; Heléne E K Sundelin Journal: Paediatr Perinat Epidemiol Date: 2022-02-16 Impact factor: 3.103
Authors: Eva Schwindt; Daniel Pfeiffer; Delphina Gomes; Sebastian Brenner; Jens-Christian Schwindt; Florian Hoffmann; Martin Olivieri Journal: Front Pediatr Date: 2022-07-26 Impact factor: 3.569