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Outcome after ischaemic stroke in childhood

Published online by Cambridge University Press:  01 July 2000

V Ganesan
Affiliation:
Neurosciences Unit, Institute of Child Health, University College London, London, UK.
A Hogan
Affiliation:
Cognitive Neuroscience Unit, Institute of Child Health, University College London, London, UK.
N Shack
Affiliation:
Great Ormond Street Hospital for Children NHS Trust, London, UK.
A Gordon
Affiliation:
Great Ormond Street Hospital for Children NHS Trust, London, UK.
E Isaacs
Affiliation:
Cognitive Neuroscience Unit, Institute of Child Health, University College London, London, UK.
F J Kirkham
Affiliation:
Neurosciences Unit, Institute of Child Health, University College London, London, UK.
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Abstract

A parental questionnaire was used to investigate the outcome for children who had had ischaemic stroke, who were seen at Great Ormond Street Hospital, London between 1990 and 1996. The results of functional assessments carried out by a physiotherapist and an occupational therapist, and of quantitative evaluations carried out by a neuropsychologist were used for validation where possible. The relationship between clinical and radiological factors and outcome were examined. The children were aged between 3 months and 15 years at the time of stroke (median age 5 years) and the period of follow-up ranged from 3 months to 13 years (median duration 3 years). Of the 90 children for whom data were obtained, 13 (14%) had no residual impairments. Outcome was good in 37 children (40%) and poor in 53 (60%) (defined according to whether impairments interfered with daily life). Agreement, as measured by Cohen's kappa, was good or very good between the parents' responses and the qualitative measures provided by the medical professionals and the therapists, but only fair to moderate for the quantitative measures provided by the neuropsychologists. This may reflect different parental perceptions of the physical and cognitive aspects of outcome. Younger age at time of the stroke was the only significant predictor of adverse outcome.

Type
Original Articles
Copyright
© 2000 Mac Keith Press

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