Objective:

To describe diagnostic work-up and treatment practices for childhood stroke in Southern Finland, using population-based real-world data from HUS Helsinki University Hospital.

Approach:

• Study Design: A retrospective observational study based on hospital data and chart review of paediatric stroke treated at HUS Helsinki University Hospital.
• Data Collection: Pseudonymized patient-level data were retrieved from electronic health records, including demographics, diagnoses, imaging, and treatments.
• Cohort Creation: The cohort included patients aged 1 month–18 years with an ICD-10 discharge diagnosis of cerebral infarction or suspected stroke.
• Diagnostic Protocol: Routine diagnostic protocol included MRI with MRA, thrombophilia testing, and cardiology assessment.

Key Findings:

• Childhood stroke accounts for 1% of all strokes but has a distinct aetiology and management compared to adult stroke.
• Mortality in paediatric stroke is reported to be ~10%–25%, with recurrence up to 25% and persistent neurological deficits in up to 66%.
• Technological advances have improved diagnosis and management, including the use of endovascular thrombectomy.

Interpretation:

The study highlights the complexities in diagnosing and managing childhood stroke and the need for tailored approaches.

Limitations:

• The study is retrospective and may be subject to underestimation related to hospital coding.
• Infection-related aetiologies were recorded broadly without pathogen-specific analysis.

Conclusion:

The findings emphasize the importance of accurate diagnosis and management strategies for childhood stroke.