Posterior Circulation Stroke in Manitoba Children: A Population Based Longitudinal Study of Clinical Presentation and Outcome
Bibliographic record
Abstract
This study is a retrospective review of a population-based cohort of children with diagnosis of posterior circulation arterial ischemic stroke (PAIS) in Manitoba. Children were consecutively enrolled in the Canadian Pediatric Ischemic Stroke Registry and the Manitoba Pediatric Stroke Database. We examined demographics, clinical and radiological presentation, treatment and outcome of children with PAIS. We also examined the clinical and radiological predictors of outcome in our study cohort using the Pediatric Stroke Outcome Measure (PSOM). Between 1992 and 2010, 24 patients met inclusion criteria, 54.2% male, and average age 4.9 years. Follow-up data at 24 months was available for 20 patients. For pediatric PAIS in Manitoba, an incidence rate of 1 person per 10,000 if followed for 18 years was estimated. Our reported ratio of PAIS to AIS is 20%, which corresponds with previous data of PAIS comprising 15-20% of AIS with incidence of all AIS being 2.5 - 3/100,000 per year3-9. Warning symptoms were present in one-third, and identifiable risk factors found in two thirds of the cohort. We found poor outcomes in aboriginal patients (45.8%, p=0.003), high PedsNIHSS score (p=0.02), patients with vasculopathy (25%, p=0.05), bilateral infarcts (42%, p=0.003), large caliber artery infarcts (53%, p=0.02) and occipital lobe infarcts (42%, p=0.04). Abnormalities found on vascular imaging (performed in 62.5%) trended towards recurrence (p=0.07). Outcome at 3, 12 and 24 months was correlated (p<0.001). The incidence rate, as well as predictors of outcome and recurrence, is valuable clinical information that will help direct treatment and prognostication of children with PAIS.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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".