Long-term assessment needed after childhood stroke, study finds

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CHILDREN and babies have a much larger window for recovery than adults after stroke, new research has found, but rehabilitation takes longer.

Researchers say they hope findings from the first study to evaluate the motor function of childhood stroke across the first year post-event, will give parents more reassurance about what to expect.

The Murdoch Childrens Research Institute study looked at 64 children; neonates aged up to one month, preschoolers, and primary school aged children.

They were followed up at four time points after ischaemic stroke; in the acute phase, one month later, six and 12 months.

Lead researcher Anna Cooper said while motor impairments were the most common side effects of paediatric stroke, outcomes were different depending on when the stroke occurred.

With infants, they found it was usual for them to struggle reaching motor function milestones at around 4-5 months of age, not because the brain injury was worsening but because the learning of new skills revealed impairments.
While both preschoolers and older children showed gradual improvement over the year, preschoolers performed better at all time points.

Researchers say this suggests they have the best recovery potential, with the best balance between brain plasticity and acquired skills.

“With adults we know there is a critical window 3-6 months after stroke where they have an optimal time for recovery,” Ms Cooper said.

“But we found this doesn’t apply to children. We didn’t see a plateau in any of the age groups, instead their abilities constantly changed over the year.”

Every year one in 50,000 Australian kids will have a stroke, while one in every 2300-5000 newborns will have a stroke before they are born.

Ms Cooper said the findings, published today in the journal Paediatrics, showed that children needed to be monitored and assessed over the long-term.

“We know that interventions and rehabilitation work,” Ms Cooper said.

“This shows we need to be involved with these children over the long-term, because their recovery is not short. Their recovery continues beyond the first year.”

Jade Abela was told her daughter Alexis would likely never live independently after suffering a stroke in utero.

While she waited three months for her baby to be referred to formal therapy, she started her own rehabilitation such as pinning Alexis’ strong arm to her side so she would use her left.

She placed all the toys to the left of her bouncer so her baby would reach.

Now, doctors are amazed that this 2 ½-year-old is walking and playing like her friends, albeit with weakness on her left side.

“We’ve worked damn hard to get her to this point, but even now we don’t know what’s ahead for her,” Ms Abela said.

Source > http://www.heraldsun.com.au/news/victoria/longterm-assessment-needed-after-childhood-stroke-study-finds/news-story/78df2a25f3c52569149d734820f53788

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