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23.08.2019 | Original Communication

Arterial ischemic stroke in infants, children, and adolescents: results of a Germany-wide surveillance study 2015–2017

verfasst von: Lucia Gerstl, Raphael Weinberger, Florian Heinen, Michaela V. Bonfert, Ingo Borggraefe, A. Sebastian Schroeder, Moritz Tacke, Mirjam N. Landgraf, Katharina Vill, Karin Kurnik, Anna-Lisa Sorg, Martin Olivieri

Erschienen in: Journal of Neurology | Ausgabe 12/2019

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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.

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Titel: Arterial ischemic stroke in infants, children, and adolescents: results of a Germany-wide surveillance study 2015–2017
verfasst von: Lucia Gerstl
Raphael Weinberger
Florian Heinen
Michaela V. Bonfert
Ingo Borggraefe
A. Sebastian Schroeder
Moritz Tacke
Mirjam N. Landgraf
Katharina Vill
Karin Kurnik
Anna-Lisa Sorg
Martin Olivieri
Publikationsdatum: 23.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 12/2019
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-019-09508-5

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