title: Outcomes in children with hemorrhagic stroke.
abstract: OBJECTIVE
  To determine if a specific intracerebral hemorrhage ratio predicts poor outcome; whether predictors of outcome in adults, specifically hemorrhage location, ventricular involvement, or initial Glasgow Coma Scale score, predict outcome in childhood hemorrhagic stroke; and whether the cause of hemorrhagic stroke predicts outcome.
  
  
  METHODS
  Retrospective case study. SETTING A single tertiary care pediatric hospital.
  
  
  METHODS
  Fifty-nine cases who had nontraumatic hemorrhages.
  
  
  METHODS
  We examined whether hemorrhage volume, location, initial Glasgow Coma Scale score, or associated diagnoses predicted outcomes. We contacted survivors and parents and assessed outcomes using measures of neurological function, quality of life, and caregiver stress.
  
  
  RESULTS
  Twenty died of the hemorrhage or associated illnesses, and we obtained follow-up on 19 survivors. Most survivors had mild to moderate neurological deficits, but many reported impaired school or physical functioning. Increasing hemorrhage volume predicted poorer neurological outcomes and poorer quality-of-life ratings among survivors. Subjects who had intracranial vascular anomalies had the best outcomes of the group. Associated diagnoses strongly predicted scores on the parent- and child-rated quality-of-life measures. In contrast to what has been reported in adult studies, initial Glasgow Coma Scale score, primary location of the hemorrhage, and ventricular hemorrhage did not significantly predict outcomes, although ventricular hemorrhage was associated with trends toward poorer outcomes.
  
  
  CONCLUSIONS
  The mortality of hemorrhagic stroke in children is lower than that in adults. Childhood survivors tend to have mild to moderate physical deficits, but they may have significant impairment in other domains such as school functioning.
authors.affiliation: Department of Neurology, The Ohio State University, OH, USA. warren.lo@nationwidechildrens.org
authors.forename: Warren D
authors.initials: WD
authors.lastname: Lo
authors.forename: Christine
authors.initials: C
authors.lastname: Hajek
authors.forename: Christopher
authors.initials: C
authors.lastname: Pappa
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Nicholas
authors.initials: N
authors.lastname: Zumberge
mesh_terms: D000293:Adolescent; D000328:Adult; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care; D016896:Treatment Outcome; D055815:Young Adult