Epidemiology of Childhood Stroke in Estonia

Laugesaar, Rael; Kolk, Anneli; Uustalu, Ülle; Ilves, Pilvi; Tomberg, Tiiu; Talvik, Inga; Köbas, Kristel; Sander, Valentin; Talvik, Tiina

doi:10.1016/j.pediatrneurol.2009.08.009

« Previous Next »Pediatric Neurology
Volume 42, Issue 2 , Pages 93-100, February 2010

Epidemiology of Childhood Stroke in Estonia

Rael Laugesaar, MD
- Department of Pediatrics, University of Tartu, Tartu, Estonia
Anneli Kolk, PhD
- Department of Pediatrics, University of Tartu, Tartu, Estonia
- Department of Neurology and Neurorehabilitation, Children's Clinic of Tartu University Hospital, Tartu, Estonia
Ülle Uustalu, MD
- Emergency Department, Tallinn Children's Hospital, Tallinn, Estonia
Pilvi Ilves, PhD
- Department of Radiology, Tartu University Hospital, Tartu, Estonia
Tiiu Tomberg, PhD
- Department of Radiology, Tartu University Hospital, Tartu, Estonia
- Department of Neurology and Neurosurgery, Tartu University, Tartu, Estonia
Inga Talvik, DMSc
- Department of Neurology and Neurorehabilitation, Children's Clinic of Tartu University Hospital, Tartu, Estonia
Kristel Köbas, MD
- Unit of Pediatrics, Children's Clinic of Tartu University Hospital, Tartu, Estonia
Valentin Sander, MD
- Department of Neurology, Tallinn Children's Hospital, Tallinn, Estonia
Tiina Talvik, DMSc
- Department of Pediatrics, University of Tartu, Tartu, Estonia
- Department of Neurology and Neurorehabilitation, Children's Clinic of Tartu University Hospital, Tartu, Estonia
- Communications should be addressed to: Dr. Tiina Talvik; Department of Neurology and Neurorehabilitation; Children's Clinic of Tartu University Hospital; Lunini 6; 51014 Tartu, Estonia.

Received 26 March 2009; accepted 12 August 2009.

We investigated the incidence and 30-day case-fatality of childhood stroke in Estonia, and clinical signs and risk factors of childhood stroke. A retrospective (1995-2003) and prospective study (2004-2006) of childhood stroke (arterial ischemic, hemorrhagic, and sinovenous thrombosis) and transient ischemic attack was conducted. Stroke-incidence calculation was based on the prospective study. Clinical diagnoses of stroke were confirmed by neuroradiology. The incidence rate of childhood stroke in Estonia was 2.73/100,000 person-years for children aged 30 days to 18 years: 1.61/100,000 for arterial ischemic stroke, 0.87/100,000 for hemorrhagic stroke, 0.25/100,000 for sinovenous thrombosis, and 0.37/100,000 for transient ischemic attack. No arterial ischemic stroke patients died within 30 days, but case-fatality for intracerebral hemorrhage was 46%. Focal signs occurred in 100% of arterial ischemic strokes and 64% of intracerebral hemorrhage cases. Risk factors were identified in 35/48 (73%) children with cerebrovascular attacks. Six children with arterial ischemic stroke (6/24, 25%) manifested more than one risk factor. The incidence rate of childhood stroke in Estonia is similar to that in earlier data.