Get Stroke Notes Newsletter, Winter 2011 Pediatric Stroke Program - Chop

An IV injection of recombinant tissue plasminogen activator (TPA) is the gold standard treatment for ischemic stroke. The two types of TPA are () and (). An injection of TPA is usually given through a vein in the arm within the first three hours.

Pediatric stroke is a rare condition affecting one in every 4,000 newborns and an additional 2,000 older children each year. Stroke is a type of blood vessel (cerebrovascular) disorder. Strokes can be categorized as ischemic (caused by insufficient blood flow) and hemorrhagic (caused by bleeding into the brain).

The incidence of pediatric stroke is approximately 1.2 to 13 cases per 100,000 children under 18, but due to potential misdiagnoses or a lack of clinical suspicion and workup, these estimates are likely low [1,2,3].

While adults often experience one-sided facial droop, speech difficulties, and muscle weakness, common stroke symptoms in children include: Weakness on one side of the body. Trouble walking. Coordination issues.

As with adults, without prompt and appropriate treatment, stroke in children can be life threatening and requires immediate medical attention. Stroke is among the top 10 causes of death in children. Pediatric stroke can also cause neurologic disability, with a risk of permanent long-term cognitive and motor impairment.

Further technological advances using telestroke and mobile stroke units in the prehospital setting have increased r-tPA utilization and reduced delays to treatment. This review will discuss the most recent developments in acute stroke treatment and improved systems for their delivery in current practice.

Abstract. Though rare, stroke in infants and children is an important cause of mortality and chronic morbidity in the pediatric population. Neuroimaging advances and implementation of pediatric stroke care protocols have led to the ability to rapidly diagnose stroke and in many cases determine the stroke etiology.

Outcome. In-hospital mortality from pediatric stroke is approximately 3%. Almost half of children with AIS have neurologic deficits, with the majority having hemiparesis.