The aim of the study is to evaluate long-term neurological outcome in children with Arterial Ischemic Stroke (AIS) and explore predictive factors that affect poor outcome.

Stroke ranks among the top 10 causes of death in children. In more than half of the surviving children with stroke, the risk of motor, behavioral and cognitive disorders and epilepsy results in major long-term personal, family and social consequences. The personal and societal costs of paediatric stroke are increasingly recognized and are higher than for an adult, due to the longer life expectancy.

Patients: 56 patients (31male/25female) aged of 1month to 17years who were treated at M. Iashvili Children’s Central Hospital, Tbilisi, Georgia, with the onset of stroke from 2007 to 2017 were included. 

 Methods: Data were collected from medical records included demographic variables, clinical characteristics, neurological deficit at onset, radiological features – affected arteries, vascular distribution areas involved, risk-factors/etiology, presence of stroke recurrence and status at discharge. Neurological deficit severity based on the scores of Paediatric Stroke Outcome Measure (PSOM) was assigned for each of the following 5‘spheres’: right sensorimotor and left sensorimotor (including visual, hearing, motor and somatosensory functions); language production, language comprehension; cognitive and behavioural performance.

Long-term outcome was evaluated at least 1 year after stroke (mean 2 to 7 years). 

According to PSOM scores neurological outcome was favourable in 69.6% of patients (28without and 11with mild neurological deficits), and unfavourable in 30.4% (5with moderate and 12with severe deficits).

The reported outcome after childhood stroke outcome was variable with long-term neurological deficits in one third of the patients. Outcome was worse in male, in patients of younger ages at stroke and in recurrent stroke; Seizures at presentation was predictive factor for poor outcome. Multiple infarcts, stroke size, and combined cortical and subcortical involvement were associated with poor outcome.