title: Acute ischemic stroke in children versus young adults.
abstract: OBJECTIVE
  The aim of this study was to compare children and young adults with acute ischemic stroke (AIS) in 2 large registries.
  
  
  METHODS
  We compared clinical characteristics, stroke etiology, workup, and outcome (modified Rankin scale score [mRS] at 3-6 months) in children (1 month-16 years) and young adults (16.1-45 years) with AIS. Data of children were collected prospectively in the nationwide Swiss NeuroPediatric Stroke Registry, young adults in the Bernese stroke database. Outcome (mRS) and stroke severity (pediatric adaptation of the National Institutes of Health stroke scale [PedNIHSS]) in children were calculated retrospectively.
  
  
  RESULTS
  From January 2000 to December 2008, 128 children and 199 young adults suffered from an AIS. Children were more likely to be male than young adults (62%/49%, p = 0.023) and less frequently had hypertension (p = 0.001), hypercholesterolemia (p = 0.003), and a family history of stroke (p = 0.048). Stroke severity was similar in children and young adults (median PedNIHSS/NIHSS 5/6; p = 0.102). Stroke etiology (original TOAST classification) was more likely to be "other determined cause" in children than in young adults (51%/29%; p < .001). Cervicocerebral artery dissections were less frequent in children than in young adults (10%/23%; p = 0.005). Outcome at 3 to 6 months did not differ between children and young adults (p = 0.907); 59% of children and 60% of young adults had a favorable outcome (mRS 0-1). Mortality was similar among children and young adults (4%/6%; p = 0.436). In multivariate analysis, low PedNIHSS/NIHSS was the most important predictor of favorable outcome (p < 0.001).
  
  
  CONCLUSIONS
  Although stroke etiology and risk factors in children and young adults are different, stroke severity and clinical outcome were similar in both groups.
authors.affiliation: Department of Pediatric Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bigi
authors.forename: Urs
authors.initials: U
authors.lastname: Fischer
authors.forename: Edith
authors.initials: E
authors.lastname: Wehrli
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: Eugen
authors.initials: E
authors.lastname: Boltshauser
authors.forename: Sarah
authors.initials: S
authors.lastname: Bürki
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Jeannet
authors.forename: Joel
authors.initials: J
authors.lastname: Fluss
authors.forename: Peter
authors.initials: P
authors.lastname: Weber
authors.forename: Krassen
authors.initials: K
authors.lastname: Nedeltchev
authors.forename: Marwan
authors.initials: M
authors.lastname: El-Koussy
authors.forename: Maja
authors.initials: M
authors.lastname: Steinlin
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002545:Brain Ischemia / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult