Aim: To study functional outcome in children aged 1 month to 18 years after paediatric arterial ischaemic stroke (PAIS) and to identify risk factors influencing their quality of life. Method: In a consecutive series of 76 children (35 males 41 females, median age at diagnosis 2y 6mo, range 1mo-17y 2mo; median length of follow-up 2y 4mo, range [7mo-10y 6mo]) with PAIS diagnosed at the Erasmus Medical Centre Sophia Children's Hospital between 1997 and 2006, we collected clinical, biochemical, and radiological data prospectively. In 66 children surviving at least 1 year after PAIS, functional outcome could be evaluated with the World Health Organization's International Classification of Impairments, Disabilities and Handicaps. Results: Significant risk factors at presentation for a poor neurological outcome were young age, infarction in the right middle cerebral artery territory, and fever at presentation. Fifty-four % of children had severe neurological impairments at 12 months after PAIS, and at last follow-up more than half needed remedial teaching, special education, or institutionalization. Health-related quality of life (HRQOL) questionnaires showed a significantly lower HRQOL in all age groups. Children with a longer follow-up had a lower HRQOL in the cognitive functioning domain. Interpretation: Our study shows significant morbidity and mortality and a reduced HRQOL after PAIS depending on age, fever at presentation, and infarction in the right middle cerebral artery territory. © The Authors. Journal compilation,
Developmental Medicine and Child Neurology
Erasmus MC: University Medical Center Rotterdam

Cnossen, M.H, Aarsen, F.K, van den Akker, S.L.J, Danen, R, Appel, I.M, Steyerberg, E.W, & Catsman-Berrevoets, C.E. (2010). Paediatric arterial ischaemic stroke: Functional outcome and risk factors. Developmental Medicine and Child Neurology, 52(4), 394–399. doi:10.1111/j.1469-8749.2009.03580.x