Ozturk Gulten, Biyikli Erhan, Unver Olcay, Dogru Omer, Saygi Evrim Karadag, Baltacioglu Feyyaz, Turkdogan Dilsad
Pediatric Neurology Department, Marmara University Medical Faculty Pendik Research and Training Hospital, Istanbul 34899, Turkey.
Radiology Department, Marmara University Medical Faculty Pendik Research and Training Hospital, Istanbul 34899, Turkey.
Children (Basel). 2025 Mar 24;12(4):407. doi: 10.3390/children12040407.
This study presents long-term data of pediatric AIS patients with a favorable initial clinical presentation who were followed by a tertiary pediatric neurology clinic with a well-organized stroke team.
Patients who were diagnosed with AIS at pediatric age (28 days-18 years) and followed for at least 5 years by the same clinic were included in this study. The clinical and demographical characteristics of the patients were retrospectively collected from their medical records. At their last visit, the modified Rankin scale (mRS) and Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) were administered, and a neurological examination was performed.
A total of 32 patients (20 of whom were male, 62.5%) were included in this study. Their mean age at the time of the study was 162.62 ± 64.4 (62-300) months. The mean age at first ischemic stroke was 77.39 ± 61.93 (0.5-180) months, and the mean follow-up duration was 85.44 ± 20.52 (60-121) months. Seventeen patients (53.3%) reported normal daily functions at the last visit. A younger presentation age (≤60 months) was related to a longer hospital admission duration (24 h vs. 9 h) and worse long-term functional outcomes ( = 0.023). The affected vascular territory did not have any significant effect on long-term clinical outcomes ( = 0.550). Anticoagulant treatment alone was consistent with a worse prognosis compared to antithrombotic treatment alone or the combination of both ( = 0.026). PSOM-SNE scores were helpful in detecting some mild cognitive and language dysfunctions in patients with favorable mRS scores and subtle neurological sequelae.
Pediatric AIS with a mild presentation has some degree of long-term morbidity, even when handled at well-organized stroke centers. A younger presentation age has the highest risk of long-term neurological sequelae.
本研究呈现了小儿急性缺血性卒中（AIS）患者的长期数据，这些患者初始临床表现良好，由一家配备完善卒中团队的三级小儿神经科诊所进行随访。
本研究纳入了在小儿期（28天至18岁）被诊断为AIS且由同一家诊所随访至少5年的患者。从他们的病历中回顾性收集患者的临床和人口统计学特征。在他们最后一次就诊时，使用改良Rankin量表（mRS）和小儿卒中结局测量简短神经检查（PSOM-SNE）进行评估，并进行神经系统检查。
本研究共纳入32例患者（其中20例为男性，占62.5%）。研究时他们的平均年龄为162.62±64.4（62 - 300）个月。首次缺血性卒中的平均年龄为77.39±61.93（0.5 - 180）个月，平均随访时长为85.44±20.52（60 - 121）个月。17例患者（53.3%）在最后一次就诊时报告日常功能正常。发病年龄较小（≤60个月）与住院时间较长（24小时对9小时）以及较差的长期功能结局相关（P = 0.023）。受累血管区域对长期临床结局没有显著影响（P = 0.550）。与单独抗血栓治疗或两者联合相比，单独抗凝治疗与更差的预后相关（P = 0.026）。PSOM-SNE评分有助于检测mRS评分良好且有轻微神经后遗症的患者中的一些轻度认知和语言功能障碍。
即使在组织完善的卒中中心进行治疗，轻度表现的小儿AIS仍有一定程度的长期发病率。发病年龄越小，长期神经后遗症的风险越高。
