An Update on Pediatric Stroke Protocol

Abstract

Pediatric stroke is relatively rare, with approximately 1000 childhood strokes in the United States per year. However, the occurrence of stroke in children leads to significant morbidity and mortality, warranting the development proven screening tools, protocols, and treatment options. Because significant delays in seeking medical attention can occur, time to recognition of pediatric stroke in the emergency department is uniquely challenging and critical. Once recognized, a trained multidisciplinary team with a multifaceted approach is needed to provide the best possible outcome for the patient. Key elements of the pediatric stroke protocol should include recognition tools, stroke alert mechanism, stroke order sets, timely imaging, laboratory evaluation, and treatment options. Substantial advancements have been made in the field of pediatric stroke protocols mainly due to formation of international consortiums and clinical trial. Despite significant progress, treatment options remain controversial.

An Adolescent Male With Hand Tingling and Weakness

“…The pediatric code stroke protocol was activated. 1 Initial laboratory evaluation was unremarkable, and computed tomography of the brain demonstrated no midline shift or obvious intracranial/intraventricular hemorrhage. Neurology was consulted while awaiting results of the magnetic resonance imaging (MRI)/angiography of the brain.…”

The Genetic Basis of Strokes in Pediatric Populations and Insight into New Therapeutic Options

“…In the study carried out by Amlie-Lefond, it was stated that mortality following AIS ranged between 6-10% in children, while more than 75% of those who suffered AIS are being associated with long-term neurological deficits [7]. McKinney and colleagues have stressed that for more than half of children with AIS, there is an association with a decreased quality of life [3].…”

“…The incidence of strokes in children ranges from around 2-3 per 100,000 births yearly, with the incidence being higher in neonates, ranging between 25-40 per 100,000 children, and even higher in premature neonates, with estimates around 100 per 100,000 children [3].…”

Perfil epidemiológico sobre lesão encefálica adquirida na infância em centro de reabilitação / Epidemiological profile of childhood-acquired brain injury in a rehabilitation center

“…Eles podem se manifestar de diferentes formas a depender da localização da artéria acometida, os fatores de risco subjacentes e a idade do paciente. O AVC em crianças mais jovens costuma gerar sintomas inespecíficos, como convulsões e estado mental alterado, principalmente naquelas menores de um ano de idade, enquanto crianças mais velhas costumam apresentar os déficits neurológicos focais, como a hemiplegia 9,10 .…”