22. European Stroke Conference 117 Stroke prognosis Stroke in young adults in Serbia in period 2007-2011: a long term outcome A.M. Pavlovic1, D. Jovanovic2, T. Pekmezovic3, T. Svabic Medjedovic4, N. Veselinovic5, M. Petro-vic6, M. Budimkic Stefanovic7, O. Stojiljkovic8, M. Norton9, Lj, Beslac Bumbasirevic10, N. Sternic11 Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Bel-grade, SERBIA1, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA2, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA3, Neurology Clinic, Clinical Center of Serbia, Facul-ty of Medicine, University of Belgrade, Belgrade, SERBIA4, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA5, Neurology Clinic, Clin-ical Center of Kragujevac, Faculty of Medicine, University of Kragujevac, Kragujevac, SERBIA6, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA7, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA8, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA9, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA10, Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, SERBIA11 Background. Although rare, stroke at a young age is of great medical and socio-economic impor-tance. We aimed to analyze long-term outcome of first-ever ischemic stroke in patients aged 18- 45, treated at university hospital. Methods. We analyzed data for period January 1st 2007- January 1st 2012 from Database of Young Stroke Patients, who underwent comprehensive stroke etiology assessment. Baseline demographic data, risk factors, TOAST classification, NIHSS and modified Rankin scale (mRS) scores were analyzed. In all participants we determined mRS and 36-Item Short Form Survey Physical Composite Score (PCS) and Mental Composite Score (MCS) and employ-ment status 12-48 months after ictus. Stroke recurrence was noted. Results. We enrolled 80 patients, aged 22-45, mean 37.6 years, 24 (30.0%) males. Stroke etiology was classified as large artery dis-ease in 9 (11.3%), cardioembolism in 5 (6.3%), small artery occlusion in 15 (18.7%), rare etiologies in 20 (25.0%) and undetermined cause in 31 (38.7%) patients. In group with rare etiologies, patients were most frequently diagnosed with arterial dissection and moya-moya disease (25.0% each) and cerebral venous thrombosis (20.0%), followed by fibromuscular dysplasia and antiphospholipid syn-drome. Admission mRS ranged from 0-4 and follow-up 0-2 (median for both 1). One third (28.5%) of patients did not return to previous job; non-working status did not correlate with TOAST classi-fication (p=0.290) or baseline NIHSS (p=0.692) but did correlate with discharge (p=0.038) and fol-low- up mRS (p=0.002), PCS (p=0.0015) and MCS scores (p=0.0042). Excellent correlation was de-tected between outcome mRS and PCS (r=-0.792, p<0.0001) and MCS (r=-0.583, p=0.0028). Stroke recurrence was documented in 16.7% of patients. Conclusion. Stroke in young in our population has good prognosis in regard to functional status and stroke recurrence. Regaining previous professional roles depends on functional recovery. 342 © 2013 S. Karger AG, Basel Scientific Programme 118 Stroke prognosis Stroke Outcome Prognostication in the Critical Care Setting I. Yau1, N. Dlamini2, R. Askalan3, M. Moharir4, D. MacGregor5, G. deVeber6 Hospital for Sick Children, Toronto, CANADA1, Hospital for Sick Children, Toronto, CANADA2, Hospital for Sick Children, Toronto, CANADA3, Hospital for Sick Children, Toronto, CANADA4, Hospital for Sick Children, Toronto, CANADA5, Hospital for Sick Children, Toronto, CANADA6 Background: Prognostication with unilateral large territory anterior circulation arterial ischaemic stroke (LAIS) in the critical care setting is challenging. Perceptions that active medical management is futile present a potential barrier to acute stroke therapies for such children. Objective To determine positive outcomes in children requiring critical care unit support following LAIS. To highlight limitations in using diffusion weighted imaging (DWI) findings for LAIS prog-nostication. Method: We report prospectively collected clinical and radiological findings of 5 children admitted Nov 2008-Jan 2010 to critical care following LAIS. Outcome data including video recordings and Paediatric Stroke Outcome measures at follow-up were obtained in all. Results : Among 5 children with LAIS (2 male; median age 0.58 yrs, range 2 days – 6.33 yrs) arte-rial territories involved were middle cerebral artery alone (two), middle and anterior cerebral artery (one) and middle and posterior cerebral artery (one). Based on history and LAIS extent critical care staff withdrew active medical support (one), and proposed futility of active treatment or prognos-tication of profound neurological disability (four). All survived and at median of.8 years (1.0-2.9 years) follow-up. Both previously ambulant children and both neonates attained/regained ambula-tion by 18 months. The 7 month-old infant at stroke sat independently at two years. Conclusion : Predicting outcome and decision making following large territory arterial ischaemic stroke in the critical care setting is challenging. We suggest caution in the interpretation of the sig-nificance and prognostic value of history and extent of DWI in this setting.
Karger_ESC London_2013
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