Pediatric Stroke Recovery: A Descriptive Analysis

Kim C-T, Han J, Kim H. Pediatric stroke recovery: a descriptive analysis.ObjectiveTo investigate recovery patterns and potential prognostic factors of pediatric stroke.DesignRetrospective study.SettingAcute rehabilitation at a university-based children's hospital.ParticipantsChildren (N=44; 25 boys, 19 girls; age range, 8mo–17y) with diagnosis of first-ever stroke.InterventionsNot applicable.Main Outcome MeasuresFunctional outcomes at discharge and 1-year follow-up. Modified Brunnstrom stages, Gross Motor Function Classification System, activities of daily living (ADLs), swallowing, speech, and sphincter function were measured.ResultsRecovery of swallowing function occurred earlier than other functions in the first 2 to 3 months poststroke. Less than half of the patients were able to use the affected arms and legs without assistive devices. Eleven of 32 patients who initially had poor body control became ambulatory without assistive devices. A total of 18 of 44 patients were able to walk without assistive devices. Bilateral hemisphere lesions and flaccid muscle tone of the affected extremity at stroke onset had a less favorable prognosis in terms of ambulation and ADLs. Hemorrhagic strokes without surgical complications had a better prognosis than nonhemorrhagic strokes.ConclusionsSimilar to the adult stroke population, most of the functional recovery in pediatric stroke occurs within the first 2 to 3 months after stroke, but the quality of functional recovery was better in the pediatric population. The lesion size of the stroke was found to be related to prognosis. Additional large cohort studies are suggested to understand the complex similarities and differences in recovery between pediatric and adult stroke.