Insights into Pediatric Strokes

A recent study published online in the Annals of Emergency Medicine provides the first look at the differences between hemorrhagic and ischemic stroke in children.1 The results indicate a need for more rapid identification of stroke symptoms by pre-hospital providers and emergency room physicians.

 

According to one of the study’s author Franz Babl, MD, MPH, the symptoms and signs of stroke are similar in adults and children, but are often missed in children because it is so rare. Instead, it was misdiagnosed as migraine, seizure or encephalitis.

 

In the study, acute ischemic stroke patients presented with symptoms of focal limb weakness, facial weakness and speech disturbance. Few presented with vomiting and altered mental status. Most patients with acute ischemic stroke had a Glasgow Coma Scale score of 14 or greater and presented with at least one focal neurologic sign.

 

Hemorrhagic stroke presented with headache, vomiting and altered mental status. The GCS score in hemorrhagic stroke was less than 14 in 38% and less than 8 in 19% of the patients. Less than one third of patients had focal limb weakness, facial weakness or slurred speech.

 

As with adults, rapid recognition, response and treatment are critical to improving outcomes.

Reference

  1. Yock-Corrales A, Mackay MT, et al. Acute Childhood Arterial Ischemic and Hemorrhagic Stroke in the Emergency Department. Ann Emerg Med. 2011 Feb 11 [Epub ahead of print]. doi:10.1016/j.annemergmed.2010.10.013

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