Long-term neurological and psychiatric outcomes after paediatric arterial ischaemic stroke and cerebral sinovenous thrombosis

Aim: To examine long-term outcomes in children and adolescents after first-time arterial ischaemic stroke (AIS) or cerebral sinovenous thrombosis (CSVT). Method: Patients (0–18 years) diagnosed with a first-time cerebral thrombosis between 1994 and 2006 were followed until 2017 in this descriptive follow-up study. Patients were identified, and age- and sex-matched 1:10 with individuals from the general population. Data were extracted from national registries of patients. Outcomes included all-cause mortality, and hospital diagnoses of neurological and psychiatric disorders after cerebral thrombosis. Results: A total of 251 patients with cerebral thrombosis were followed up for a median of 16 years (interquartile range 13 years 1 month–19 years 4 months). Cumulative all-cause mortality at 23 years 8 months was 11.4% (95% confidence interval [CI] 7.1–17.9). Hazard ratios indicated an increased risk of 64.0 times (95% CI 35.3–116.0) for cerebral palsy, 17.9 times (95% CI 10.2–31.5) for vision problems, and 4.1 times (95% CI 2.0–8.4) for being diagnosed with severe mental disorders during follow-up for those with previous cerebral thrombosis compared with the general population. The risk of morbidity was significantly increased following both AIS and CSVT. Interpretation: Children and adolescents experience a higher all-cause mortality and a high risk of neurological and psychiatric diagnoses after AIS or CSVT compared with the general population.