Although stroke is often associated with the elderly, children are also affected and have the greatest risk for stroke during the first year of life. Stroke is one of the top 10 causes of death among children and up to 70% of pediatric stroke survivors have residual neurological impairment (1). Guidelines for the treatment of adult stroke are well established and hinge on both early recognition and rapid intervention; however in the case of children, stroke symptoms are often underrecognized. This is in part due to the fact that 60% of children with ischemic or hemorrhagic stroke present with generalized rather than focal symptoms.
In an effort to combat this problem, Cook Children’s Stroke and Thrombosis Program was recently awarded a grant through Medtronic to bring awareness, standardized treatment protocols and research advancements that will improve access to diagnosis and treatment of pediatric stroke. Through this generous grant, Cook Children’s plans include:
- Awareness efforts to help decrease the time it takes to recognize, diagnose and treat pediatric stroke with standardized drug therapies and interventions.
- Increased emotional, educational and rehabilitative support from the community and schools to patients affected by pediatric stroke; education within the state’s school districts so teachers and school-based nurse personnel are adept at recognizing pediatric stroke as a possible malady.
- Improve long-term health outcomes of pediatric stroke patients, minimizing significant impairments.
The program has already developed protocols for rapid transfer upon recognition of stroke diagnosis to aid hospitals in our referral area. Through telemedicine, our program is able to use real time review of brain imaging at referring hospitals to provide guidance on stroke interventions to stabilize the patient prior to transporting them to Cook Children’s. Our program is diligently working to expand equitable access to acute stroke care through the creation of a written acute stroke care institutional protocol. The dissemination of this protocol would first be shared with referring hospitals within our 6 County region. Once hospitals capable of providing early diagnosis and preliminary intervention to pediatric stroke patients have been identified, the Program will coordinate education and training with those centers, including their Emergency department, radiology and pharmacy, for safe administration of interventions. The program is currently providing educational conferences for the physicians, medical staff, EMS and transport service providers of such centers.
With more than 7 million children living in Texas, our clinical reach represents nearly 1 in 10 children currently living in the United States. Rapidly evolving technologies are being developed in the treatment of adult stroke to increase the chances of a full recovery. Similar technology is beginning to emerge as an option for children. Our aim is to expand access to this specialized care; not only for children within the Dallas/ Fort Worth area, but to all children within our regional referral area. Our nationally recognized transport program affords the opportunity to provide direct care access to any pediatric stroke patient within a 6 hour distance. Our standardization and dissemination of a pediatric stroke treatment protocols will impact patient care nationally.
May is Pediatric Stroke Awareness Month: share the signs of stroke.
Facial droop, Arm or leg weakness, Speech difficulty, Time to call 911
- DeVeber, G.A , Kirton, A., et al. Epidemiology and Outcomes of Arterial Ischemic Stroke in Children: The Canadian Pediatric Ischemic Stroke Registry. Pediatric Neurology. 2017; 69: 58-70.