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TOPLINE:

The age-adjusted incidence of paediatric stroke increased among Danish boys while remaining stable among girls.

METHODOLOGY:

• Researchers analysed data from Danish nationwide registries using three linked national registries: Danish National Patient Registry, Civil Registration System, and Danish Registry of Causes of Death (2013-2020).
• They identified 221 children (aged 29 days to 17 years) with first-ever stroke (127 with arterial ischaemic stroke and 83 with intracerebral haemorrhage) using International Classification of Diseases, Tenth Revision codes.
• Cases were validated via medical records and followed up until death, emigration, 5-year follow-up, or January 1, 2023, whichever came first.
• Outcomes included mortality (assessed using a Kaplan-Meier analysis), neurologic deficits (assessed using the Paediatric Stroke Outcome Measure), and sex-specific incidence trends.

TAKEAWAY:

• The overall age-adjusted incidence of stroke was 2.15 per 100,000 person-years (95% CI, 1.88-2.45), with a significant annual increase in the incidence of arterial ischaemic stroke being observed among boys (0.14 per 100,000 person-years; 95% CI, 0.018-0.26); however, incidence rates remained stable among girls (all stroke subtypes: yearly change, -0.021; 95% CI, -0.16 to 0.12).
• All-cause mortality was 11% at 5 years, 7.7% at 30 days, and 10.0% at 1 year, with significantly higher mortality seen in children with intracerebral haemorrhage than in those with arterial ischaemic stroke.
• Among survivors, moderate-to-severe neurologic deficits were observed in 20.2% with arterial ischaemic stroke and 23.1% with intracerebral haemorrhage.
• No significant difference in mortality was observed between early (2013-2016) and later (2017-2020) cohorts (P = .77), despite the increase in the incidence of stroke among boys.

IN PRACTICE:

"Morbidity and mortality after stroke were substantial, highlighting the need for further improvements in acute pediatric stroke management, secondary prevention, and rehabilitation," the authors wrote.

SOURCE:

This study, led by Julie Brix Bindslev, Department of Neurology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark, was published online on July 17, 2025, in Neurology.

LIMITATIONS:

Some stroke cases may have been missed due to the reliance on register-based diagnoses. The 8-year study period may have limited the statistical power to detect subtle trends. Although changes in the diagnostic criteria and MRI access over time could influence long-term trends, their impact is likely minimal in this context.

DISCLOSURES:

This study was supported by grants from the Novo Nordisk Foundation, Elsass Foundation, and Institute of Clinical Medicine, Copenhagen University. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.