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Posterior Circulation Stroke in Manitoba Children: A Population Based Longitudinal Study of Clinical Presentation and Outcome

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dc.contributor.supervisor Dr. Mubeen F. Rafay (Section of Pediatric Neurology, Department of Pediatrics and Child Health, University of Manitoba) and Dr. Frances Booth (Section of Pediatric Neurology, Department of Pediatrics and Child Health, University of Manitoba. en_US
dc.contributor.author Carey, Samantha M.
dc.date.accessioned 2012-03-12T15:34:38Z
dc.date.available 2012-03-12T15:34:38Z
dc.date.issued 2012-03-12
dc.identifier.uri http://hdl.handle.net/1993/5154
dc.description.abstract This study is a retrospective review of a population-based cohort of children with diagnosis of posterior circulation arterial ischemic stroke (PAIS) in Manitoba. Children were consecutively enrolled in the Canadian Pediatric Ischemic Stroke Registry and the Manitoba Pediatric Stroke Database. We examined demographics, clinical and radiological presentation, treatment and outcome of children with PAIS. We also examined the clinical and radiological predictors of outcome in our study cohort using the Pediatric Stroke Outcome Measure (PSOM). Between 1992 and 2010, 24 patients met inclusion criteria, 54.2% male, and average age 4.9 years. Follow-up data at 24 months was available for 20 patients. For pediatric PAIS in Manitoba, an incidence rate of 1 person per 10,000 if followed for 18 years was estimated. Our reported ratio of PAIS to AIS is 20%, which corresponds with previous data of PAIS comprising 15-20% of AIS with incidence of all AIS being 2.5 - 3/100,000 per year3-9. Warning symptoms were present in one-third, and identifiable risk factors found in two thirds of the cohort. We found poor outcomes in aboriginal patients (45.8%, p=0.003), high PedsNIHSS score (p=0.02), patients with vasculopathy (25%, p=0.05), bilateral infarcts (42%, p=0.003), large caliber artery infarcts (53%, p=0.02) and occipital lobe infarcts (42%, p=0.04). Abnormalities found on vascular imaging (performed in 62.5%) trended towards recurrence (p=0.07). Outcome at 3, 12 and 24 months was correlated (p<0.001). The incidence rate, as well as predictors of outcome and recurrence, is valuable clinical information that will help direct treatment and prognostication of children with PAIS. en_US
dc.subject medicine en_US
dc.title Posterior Circulation Stroke in Manitoba Children: A Population Based Longitudinal Study of Clinical Presentation and Outcome en_US
dc.degree.discipline Medicine en_US
dc.contributor.examiningcommittee Medicine en_US
dc.degree.level Bachelor of Science (B.Sc.) en_US
dc.description.note October 2011 en_US


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