Scientists have warned of an increase in the number of stroke cases in adolescents
Stroke is considered to be a disease that primarily threatens adults, but it also occurs in children. Even with reduced mortality, the effects of such disorders can persist throughout life, and access to timely diagnosis and care varies significantly from country to country. A new global study has shown that the overall damage from childhood stroke has decreased in recent decades, but the number of new cases among adolescents has increased. The information about where the problem remains most acute and which forms of stroke pose the greatest danger is in the Izvestia article.
Millions of children with stroke consequences
The researchers analyzed data on childhood stroke in 204 countries and territories from 1990 to 2021. The results of the work are published in the journal Pediatric Discovery. The scientists separately considered ischemic and hemorrhagic stroke, age groups, gender, and the level of socio-demographic development of the countries.
According to estimates, in 2021, there were about 2.7 million children and adolescents living with the consequences of a stroke in the world. Of these, 58.6% were of the ischemic type, in which the blood supply to the brain is disrupted, and 41.4% were hemorrhagic, associated with hemorrhage. At the same time, we are not talking about the number of new seizures per year, but about the prevalence of the consequences of the disease among children and adolescents.
Over the past 30 years, the number of lost years of healthy life associated with childhood stroke has decreased from about 5.9 million to 2.4 million. In 2021, about 24.7 thousand deaths were associated with it. However, the improvement in general statistics did not mean that the problem had disappeared: the dynamics varied depending on age, type of stroke and region of residence.
Teenagers turned out to be a separate risk group
Against the background of a general decline in indicators, researchers found an increase in the number of new stroke cases among adolescents aged 10 to 19 years. If in 1990 the estimated number was about 144.3 thousand, by 2021 it has grown to 152.5 thousand. In general, the incidence of new cases increased with age and peaked in the 15 to 19-year-old group.
In 2021, adolescents aged 15-19 accounted for about 81.3 thousand new cases, more than in any other selected age group. Against this background, the number of new cases among infants and young children decreased during the period under review. The authors also noted differences between the sexes: hemorrhagic stroke was more common in boys, while ischemic stroke was more common in girls.
The researchers do not explain the increase in the number of cases among teenagers by one specific reason. Their work describes global trends and differences between groups, but does not allow us to determine which factors led to the change in indicators. The authors emphasize the need for a more detailed study of the age and regional characteristics of childhood stroke.
Hemorrhages lead to most of the losses
Despite the fact that ischemic stroke accounted for a large proportion of common cases, the most severe consequences were associated with the hemorrhagic type. In 2021, it accounted for 78.3% of all lost years of healthy life and 85.9% of deaths from childhood stroke. In absolute terms, this is about 1.89 million lost years and 21.4 thousand deaths. For comparison, ischemic stroke was associated with about 525,000 lost years and 3.5 thousand deaths.
Adolescents aged 15-19 years had the heaviest burden of the disease in general. In this age group, the researchers estimated the number of years of healthy life lost at about 776.4 thousand, and the number of deaths at 8.4 thousand. At the same time, hemorrhagic stroke remained a particularly significant cause of death and disability.
The authors attribute the differences in consequences, among other things, to the availability of medical care. In cases of cerebral hemorrhage, timely diagnosis and treatment are crucial, however, in regions with limited resources, access to the necessary interventions may be difficult. A stroke can lead to motor, speech, and cognitive impairments that affect a child's future life.
The gap between the countries remains
The most difficult situation was observed in countries with a low level of socio-demographic development. In this group, from 1990 to 2021, the number of children and adolescents living with the consequences of hemorrhagic stroke increased from about 146.6 thousand to 267.2 thousand. The increase was especially noticeable among adolescents aged 15-19 years — from 48 thousand to 96 thousand cases.
Among the regions, the most pronounced increase in the prevalence of childhood stroke was recorded in West Africa, sub-Saharan Africa. In contrast, East Asia showed the most significant decline. At the country level, China was the leader in the number of children and adolescents with stroke consequences in 2021 — about 350.2 thousand. India ranked first in terms of the number of healthy years lost and new cases of the disease.
The authors note that the distribution of risk is influenced not only by medical conditions, but also by socio-economic conditions. Among the factors that can shape regional differences, they name infections, congenital heart diseases and injuries, as well as limited access to diagnosis and treatment. The researchers identify early detection of stroke, the development of emergency care and rehabilitation, especially in regions with limited resources, as priority areas.
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