This is a serious problem because, as children fall further behind in coursework, it becomes increasingly difficult for them to return to school.Short-term problems resulting from academic refusal include poor academic performance or decline in performance, alienation from peers, and conflict within the family.Although school refusal behavior is common among children with SAD, it is important to note that school refusal behavior is sometimes linked to generalized anxiety disorder or possibly a mood disorder. That being said, a majority of children with separation anxiety disorder have school refusal as a symptom. Up to 80% of children who refuse school qualify for a diagnosis of separation anxiety disorder. Home setting
Symptoms for SAD might persist even in a familiar and/or comfortable setting for the child, like the home. The child might be afraid to be in a room alone even if they know that their parent is in the next room over. They might fear being alone in the room, or going to sleep in a dark room. Problems might present themselves during bedtime, as the child might refuse to go to sleep unless their parent is near and visible. During the day, the child might "shadow" the parent and cling to their side. Workplace
Just how SAD affects a childs attendance and participation in school, their avoidance behaviors stay with them as they grow and enter adulthood. Recently, "the effects of mental illness on workplace productivity have become a prominent concern on both the national and international fronts".
Younger age
Higher severity of symptoms on the National Institutes of Health Stroke Scale
Signs of current ischemia on clinical exam
Decreased level of consciousness
Hyper dense artery sign and larger affected area on CT imaging
Higher blood glucose

Classification
Cerebral edema has been traditional classified into two major sub-types: cytotoxic and vasogenic cerebral edema. This simple classification helps guide medical decision making and treatment of patients affected with cerebral edema. There are, however, several more differentiated types including but not limited to interstitial, osmotic, hydrostatic, and high altitude associated edema. Within one affected person, many individual sub-types can be present simultaneously.The following individual sub-types have been identified:

Cytotoxic
In general, cytotoxic edema is linked to cell death in the brain through excessive cellular swelling. During cerebral ischemia for example, the blood–brain barrier remains intact but decreased blood flow and glucose supply leads to a disruption in cellular metabolism and creation of energy sources, such as adenosine triphosphate (ATP). Exhaustion of energy sources impairs functioning of the sodium and potassium pump in the cell membrane, leading to cellular retention of sodium ions. Accumulation of sodium in the cell causes a rapid uptake of water through osmosis, with subsequent swelling of the cells. The ultimate consequence of cytotoxic edema is the oncotic death of neurons. The swelling of the individual cells of the brain is the main distinguishing characteristic of cytotoxic edema, as opposed to vasogenic edema, wherein the influx of fluid is typically seen in the interstitial space rather than within the cells themselves.