Pediatric strokes puzzling but not rare

Although there is scant information on childhood strokes, the same rapid diagnosis promoted for adults should help save young brains.

By Susan J. Landers, AMNews staff. May 2, 2005.

Washington -- Strokes happen only to older people, right? Not so, say physicians who are finding the often difficult-to-detect disorder in children more frequently than brain tumors.

Getting the word out to primary care physicians is very important to Jill M. Baren, MD, associate professor in the departments of emergency medicine and pediatrics at the University of Pennsylvania. She sees an estimated two cases per week in her busy pediatric center.

In cases of childhood stroke, parents are much more likely to turn first to their primary care physicians for help, she said. "Often a young child is not talking right and it is perceived as acting out. It can be four to six days later that they show up in an emergency department."

And time is critical in stroke treatment for children, just as it is for adults. "Time is brain," Dr. Baren stressed to a group of physicians attending an April 11 scientific meeting of the American College of Emergency Physicians in Washington, D.C. However, 24 hours often elapses between the occurrence of stroke in a child and the time when they receive medical care.

There is no children's stroke program in the United States, although there is such a program at the Hospital for Sick Children in Toronto. And no management program exists beyond those developed for children with sickle cell anemia and congenital heart disease, Dr. Baren said.

For now, applying treatments developed for adults serves as the starting point for emergency department care for these children, she said.