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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(10): 692-696
DOI: 10.1590/0004-282X20170124
Article

Could infarct location predict the long-term functional outcome in childhood arterial ischemic stroke?

¿Puede la localización del infarto predecir el resultado funcional a largo plazo en el ictus isquémico arterial pediátrico?
Mauricio López-Espejo
1   Pontifícia Universidad Católica de Chile, Escuela de Medicina, Unidad de Neurología, División de Pediatria, Chile
,
Marta Hernández-Chávez
1   Pontifícia Universidad Católica de Chile, Escuela de Medicina, Unidad de Neurología, División de Pediatria, Chile
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ABSTRACT

Objective: To explore the influence of infarct location on long-term functional outcome following a first-ever arterial ischemic stroke (AIS) in non-neonate children.

Method: The MRIs of 39 children with AIS (median age 5.38 years; 36% girls; mean follow-up time 5.87 years) were prospectively evaluated. Infarct location was classified as the absence or presence of subcortical involvement. Functional outcome was measured using the modified Rankin scale (mRS) for children after the follow-up assessment. We utilized multivariate logistic regression models to estimate the odds ratios (ORs) for the outcome while adjusting for age, sex, infarct size and middle cerebral artery territory involvement (significance < 0.05).

Results: Both infarcts ≥ 4% of total brain volume (OR 9.92; CI 1.76 – 55.9; p 0.009) and the presence of subcortical involvement (OR 8.36; CI 1.76 – 53.6; p 0.025) independently increased the risk of marked functional impairment (mRS 3 to 5).

Conclusion: Infarct extension and location can help predict the extent of disability after childhood AIS.

RESUMEN

Objetivo: Para explorar la influencia de la localización del infarto sobre los resultados funcionales a largo plazo después de un primer ictus isquémico arterial (IIA) en ninos posterior a la edad neonatal.

Métodos: Se evaluaron de forma prospectiva imágenes por RM de 39 ninos con IIA (mediana de edad: 5,38 años; 36% ninas; seguimiento promedio: 5,87 anos). La localización del infarto fue clasificada como ausencia o presencia de compromiso subcortical. El resultado funcional fue medido utilizando la escala modificada de Rankin (mRS) para ninos en una evaluación al final del seguimiento. Utilizamos modelos de regresión logística multivariada para estimar los odds ratios (ORs) para el resultado ajustado para la edad, sexo, tamaño del infarto y compromiso del territorio vascular de la arteria cerebral media (significancia < 0,05).

Resultados: Tanto el tamaño del infarto > 4% del volumen encefálico total (OR 9,92; IC 1,76-55,9; p 0,009) como la presencia de compromiso subcortical (OR 8,36; IC 1,76-53,6; p 0,025) incrementaron independientemente el riesgo de presentar marcado compromiso funcional (mRS 3 a 5).

Conclusión: La extensión y localización del infarto pueden ayudar a predecir la magnitud de la discapacidad posterior a un IIA durante la niñez.

Keywords:

stroke - disability - cerebrovascular disorders - cerebral infarction

Palabras clave:

accidente cerebrovascular - trastornos cerebrovasculares - infarto cerebral


Publication History

Received: 31 March 2017

Accepted: 17 July 2017

Article published online:
04 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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