Recurrence Rate in Children With Arterial Ischemic Stroke: A Systematic Review

Aim: We conducted a systematic review to examine the recurrence rate in children with arterial ischemic stroke, including the recurrence rate according to stroke aetiology. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. PubMed and Embase were searched for English-language cohort studies published between 1 January 2000 and 19 January 2023, reporting the recurrence rate in children with AIS. Identified studies were screened by two researchers on title/abstract level and full-text level. The risk of bias was assessed using the modified Critical Appraisal Skills Programme checklist. Results: The search yielded 28 studies, including 5546 children and 684 neonates. The studies were from 14 different countries with two international cohorts. Reported recurrence rates ranged from 0.0% to 1.9% for neonatal cohorts and 1.1% to 51.9% for childhood cohorts. The median recurrence rate was 10.6% for childhood AIS cohorts. Arteriopathies represented a high-risk aetiology associated with recurrence rates of 0.0%–52.2% with a median recurrence rate of 21.8%. Conclusion: These findings indicated that subgroups of patients possess a higher recurrence risk than others. Differences between studies highlighted the need for systematic approaches to future research on predictors of recurrent AIS.