Abstract TMP100: Posterior Circulation Ischemic Stroke in Manitoba Children: A Population Based Longitudinal Study of Clinical Presentation and Outcome
Bibliographic record
Abstract
Background: In chidden, the nonspecific presentation of posterior circulation arterial ischemic strokes (PAIS) poses challenges. Additionally, PAIS differ markedly from anterior circulation strokes. Incidence data is lacking and the information about outcome in children with PAIS is limited. Objectives: This study was aimed to calculate the incidence of and to review the clinical presentation, outcome and prognostic predictors of PAIS in children. Methods: A retrospective review of a population based cohort of children, birth to 18 years, in Manitoba, Canada, with PAIS, from January 1992 to December 2010. Data regarding demographics, clinical features and outcome of children with PAIS was collected. Results: Twenty four children with PAIS, 54.2% male, average age 5 years, were identified. Our ratio of PAIS to AIS was 20%, with an estimated incidence rate of 1 person per 10,000 if followed for 15 years. Warning symptoms before stroke onset were present in 33%. Seventy-one percent presented with sensorimotor deficits, 75% with impaired consciousness and 29% with seizures or posturing. Identifiable risk factors were present in two thirds: vasculopathy 25%, infection 21%, trauma 12.5% and congenital heart disease 12.5%. Average Pediatric National Institute of Health Stroke Severity Scale (PedNIHSS) at presentation was 11. Average Pediatric Stroke Outcome Measure (PSOM) at 3 months was 1.35. We found poor outcomes in patients with aboriginal ancestry (45.8%,p=0.003), high PedNIHSS score (p=0.02), bilateral infarction(42%,p=0.003), large artery infarcts (53%,p=0.02), occipital lobe infarcts(42%,p=0.04) and presence of vasculopathy (25%,p=0.05). Presence of abnormalities on vascular imaging trended towards recurrence (p=0.07). Outcome at 3 months correlated with outcome at 12 and 24 months (p<0.001). Conclusion: Our study is the first to report a population-based incidence of PAIS in children. The incidence rate and the predictors of outcome provide valuable information that will help direct treatment and prognostication of children with PAIS. Our data calls for close observation and management of children with suspected PAIS, in particular aboriginal patients, patients with bilateral and large infarction and abnormal vascular imaging.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".