Is it time for a large, collaborative study of pediatric stroke?
OBJECTIVE
A 2002 report from the National Institute of Neurological Disorders and Stroke cited the critical importance of more childhood stroke studies. We present the incidence rate of pediatric stroke from a biethnic community-based project and calculate the population size required for future prospective studies of pediatric stroke.


METHODS
This work is part of the Brain Attack Surveillance in Corpus Christi (BASIC) project. The community of 325,000 is located in southeast Texas and is composed of approximately equal numbers of Mexican Americans (MAs) and non-Hispanic whites (NHWs). Discharge diagnosis codes from all hospitals in the county were used to identify cases of childhood stroke (age >1 month and <20 years) in 2002 and 2003, and stroke cases were validated by source document review. On the basis of the incidence rates, the population size required to complete a case-control study to examine risk factors for pediatric stroke was calculated.


RESULTS
Eight cases of pediatric stroke were identified, yielding an annual incidence rate of 4.3 per 100,000 (95% CI, 1.9 to 8.5). There were 5 cases of intracerebral hemorrhage, 1 subarachnoid hemorrhage, 1 ischemic stroke, and 1 transient ischemic attack. All of the events occurred in MAs. Depending on the prevalence of the risk factors of interest, future studies of pediatric stroke would have to draw from a population of up to 59 million children to complete a case-control study within 4 years.


CONCLUSIONS
Given the rarity of pediatric stroke, future studies will require multicenter efforts and possibly a national surveillance system.
Zahuranec
Darin B
DB
University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0316, USA.
Brown
Devin L
DL
Lisabeth
Lynda D
LD
Morgenstern
Lewis B
LB
D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology; D002309:Cardiology / Q000379:methods / Q000639:trends*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D017058:Mexican Americans; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D012106:Research / Q000639:trends*; D012107:Research Design; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D013781:Texas; D013997:Time Factors; D044465:White People