The clinical outcome of pediatric intracerebral hemorrhage (pICH) is rarely reported in a comprehensive way. In this cohort study, systematic review, and meta-analysis of patients with pICH, the authors aimed to describe the basic clinical outcomes of pICH.

Children who received treatment for pICH at the authors’ institution were prospectively enrolled in the cohort in 2008; data since 2000 were retrospectively included, and data through October 2019 were analyzed. The authors then searched PubMed and conducted a systematic review of relevant articles published since 1990. Data from the identified populations and patients from the cohort study were pooled into a multicategory meta-analysis and analyzed with regard to clinical outcomes.

Among 243 children screened for inclusion, 231 patients were included. The median (IQR) age at ictus was 9.6 (4.6–12.5) years, and 128 patients (53%) were male. After a median (IQR) follow-up of 33 (13–63) months, 132 patients (57.4%) had a favorable clinical outcome, of whom 58 (44%) had no residual symptoms. Nineteen studies were included in the meta-analysis. Overall, the proportion of children with complete recovery was 27% (95% CI 19%–36%; Q = 49.6; I² = 76%); of those with residual deficits, the complete recovery rate was 48.1% (95% CI 40%–57%; Q = 75.3; I² = 81%). When pooled with the cohort study, the aggregate case-fatality rate at the last follow-up was 17.3% (95% CI 12%–24%; Q = 101.6; I² = 81%).

Here, the authors showed that 1 in 6 children died after pICH, and the majority of children had residual neurological deficits at the latest follow-up. Results from the cohort study also indicate that children with vascular lesions as the etiology of pICH had significantly better clinical functional outcomes.

小儿脑出血 (pICH) 的临床结果很少以综合方式报道。在这项针对 pICH 患者的队列研究、系统评价和荟萃分析中，作者旨在描述 pICH 的基本临床结果。

在作者所在机构接受 pICH 治疗的儿童于 2008 年前瞻性地纳入队列；回顾性纳入2000年以来的数据，分析截至2019年10月的数据。然后，作者搜索了 PubMed，并对自 1990 年以来发表的相关文章进行了系统评价。来自队列研究的已识别人群和患者的数据被汇总到多类别荟萃分析中，并针对临床结果进行分析。

在筛选纳入的 243 名儿童中，纳入了 231 名患者。发作时的中位 (IQR) 年龄为 9.6 (4.6-12.5) 岁，128 名患者 (53%) 为男性。在中位 (IQR) 随访 33 (13-63) 个月后，132 名患者 (57.4%) 的临床结果良好，其中 58 名 (44%) 没有残留症状。19 项研究被纳入荟萃分析。总体而言，完全康复的儿童比例为 27%（95% CI 19%–36%；Q = 49.6；I ² = 76%）；在有残留缺陷的患者中，完全恢复率为 48.1%（95% CI 40%–57%；Q = 75.3；I ² = 81%）。当与队列研究合并时，最后一次随访时的总病死率为 17.3%（95% CI 12%–24%；Q = 101.6；I ² = 81%）。

在这里，作者表明六分之一的儿童在 pICH 后死亡，并且大多数儿童在最近的随访中仍有残留的神经功能缺损。队列研究的结果还表明，以血管病变为 pICH 病因的儿童具有明显更好的临床功能结果。