The outcome of 128 children diagnosed with ischemic stroke at Great Ormond Street Hospital, London, between 1990 and 1996, was evaluated first, by a parental questionnaire and subsequently, with physiotherapist and occupational therapist ratings of motor and behavioral function, and quantitative measures of cognitive function by a neuropsychologist. Data were not available for 23 patients, but 15 (11%) had died. Patients were aged 3 months to 15 years at the time of the stroke (median age, 5 years), and follow-up ranged from 3 months to 13 years (median duration, 3 years). Among 90 patients evaluated, the risk factors for stroke were moyamoya in 17, cardiac lesion in 15, sickle cell anemia (8), CNS infection (5), malignancy (6). Hemiparesis resulted in 75, and 30 presented with seizures. Outcome, defined by normal or impaired activities of daily living, was good in 40% and poor in 60%. Correlation of parents’ responses with the medical and therapist evaluations was good, but not with measures of psychological function. The younger the child at the time of the stroke, the worse the prognosis. [1]

COMMENT. The incidence of good prognosis (40%) and fatalities (11%) in this study was identical to that reported in the recent Netherlands study (see Ped Neur Briefs June 2000; 14:41).