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Title: The epidemiology, clinical features, and outcome of childhood arterial ischaemic stroke in a population-based cohort
Author: Mallick, Andrew Ashok
ISNI:       0000 0004 5358 4652
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2014
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This thesis describes the extensive evaluation of a population-based cohort of children following arterial ischaemic stroke (AIS). AIS is an important cause of acquired brain injury in children. Children with new onset AIS over a one year period living in the southern part of England were prospectively identified using mUltiple sources of ascertainment and then followed-up at 12 months post-AIS to assess outcome using a comprehensive range of assessment tools. The study identified 96 incident cases of AIS giving an incidence rate of 1.60 per 100,000 per year. Infants had the highest rate of AIS. Black and Asian children were at increased risk compared with White children. Capture-recapture analysis was used to estimate that the study ascertained 88% of cases. In most cases (83%) at least one underlying risk factor for AIS was identified. Risk factors varied by age and ethnicity. The case fatality rate was 9%. Children with underlying chronic systemic conditions had the the highest risk of death. The recurrence rate of 1 % was the lowest ever reported for a large study of childhood AIS. Using assessment tools validated for use in childhood AIS, parents judged 34% of children to have fully recovered and 44% of physician assessed children made a good outcome. The sensorimotor domain was the most affected but increasing age was associated with better sensorimotor outcome which disagrees with the commonly held view of increased plasticity in younger children but may be in-keeping with the phenomenon of early vulnerability. A range of other domains including cognitive and language domains, adaptive behaviour, participation, behaviour, and quality of life were assessed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available