Functional outcome of paediatric stroke survivors.

OBJECTIVE

To examine the medical and functional outcome of paediatric stroke survivors.

PATIENTS: Patients aged 1 month to 18 years diagnosed with stroke over a 10 year period.

MAIN OUTCOME MEASURES: Discharge functional outcome data were collected by reviewing therapy, nursing, and other chart notes relating to specific functional tasks. Current functional information, living situation, school placement, and medical outcome data were obtained in the telephone survey.

RESULTS

Fifty patients responded. The mean age at event was 8.0 years (range: 7 months to 17 years, 7 months). The mean follow-up time was 70 months. Diagnoses included: haemorrhagic (30%), thrombotic/embolic (46%), and undiagnosed (24%). At follow-up, 76% of the patients were independent in all activities of daily living (ADL), compared to 64% at hospital discharge. Younger age at onset, female gender, history of cardiac disease, and presentation with hemiparesis were significant risk factors for dependence in ADL (p < 0.05), while thrombotic/embolic aetiology demonstrated a trend (p = 0.06). Eighty-four per cent were independent in mobility, compared to 74% at discharge. Forty per cent of the patients had speech and language deficits. Of the school age children, only 50% were in a regular classroom.

CONCLUSIONS

Children and adolescents who survive stroke have good outcome for mobility and ADL skills, but more difficulty with language and cognitive recovery. Functional recovery is maintained after discharge, and functional gains occur over time with very little evidence of functional regression. Comorbidities are relatively low. All children in the group returned to a home setting.