Faye
02-23-2006, 09:40 AM
ASA: Stroke in Children Is a Difficult Diagnosis
http://www.medpagetoday.com/images/blue_dot.gif http://www.medpagetoday.com/Cardiology/Strokes/tb/2700By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Rubeen K. Israni, M.D., Fellow, Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine (http://www.medpagetoday.com/reviewer.cfm?reviewerid=422)
February 17, 2006
http://www.medpagetoday.com/images/blue_dot.gifMedPage Today Action Points
Explain to parents who ask that stroke in children is associated with a mixed set of symptoms, some of which mimic adult stroke while others, like seizure, nausea and vomiting, are more common in children.
Explain that timely treatment is as important for children as it is for adults with stroke.
These studies were presented at a conference either as abstracts or oral presentations. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.Review
Gabrielle DeVeber, M.D.
Hospital for Sick Children
TorontoORLANDO, Feb. 17 - Children are also at risk for stroke, but recognizing it in kids is challenging and treatment is complex.
So said a group of pediatric stroke specialists who reported a series of studies today at the American Stroke Association meeting here.
In adults, they said, ischemic strokes account for 88% of all strokes while in children about half are ischemic and half are hemorrhagic.
Children with ischemic stroke have many of the same symptoms as adults-sudden onset hemiplegia, aphasia, and difficulty in walking. But in children these symptoms are often attributed to "flu or acting out," said Rebecca Ichord, M.D. director of Children's Hospital of Philadelphia.
But children also have some symptoms that are very different from those in adults. For example, pediatric symptoms include headache, sleepiness, and vomiting. Moreover, 25% to 50% of children have seizure at onset of ischemic stroke, versus about 5% of adults, she said.
Nonetheless, these symptoms, too, are often misinterpreted by both parents and physicians. And while half of parents will seek medical attention within six hours of symptoms, they usually take the ailing child to a physician's office or community hospital. More hours pass, Dr. Ichord said, before children arrive at a center such as hers.
In order to better identify the timeline in pediatric ischemic stroke, Dr. Ichord conducted a prospective consecutive case series study of children treated at her center between March 2003 and November 2004.
Twelve children-seven of them male-were included in the study. The age range was two years to 17, and the average time from onset of symptoms to presentation for medical treatment was 5.6 hours.
Although the majority of children in the study were brought to medical attention promptly after the onset of their symptoms, several experienced delays approaching 24 hours before receiving a definitive diagnosis and emergency stroke-specific treatment.
http://www.medpagetoday.com/images/blue_dot.gif http://www.medpagetoday.com/Cardiology/Strokes/tb/2700By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Rubeen K. Israni, M.D., Fellow, Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine (http://www.medpagetoday.com/reviewer.cfm?reviewerid=422)
February 17, 2006
http://www.medpagetoday.com/images/blue_dot.gifMedPage Today Action Points
Explain to parents who ask that stroke in children is associated with a mixed set of symptoms, some of which mimic adult stroke while others, like seizure, nausea and vomiting, are more common in children.
Explain that timely treatment is as important for children as it is for adults with stroke.
These studies were presented at a conference either as abstracts or oral presentations. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.Review
Gabrielle DeVeber, M.D.
Hospital for Sick Children
TorontoORLANDO, Feb. 17 - Children are also at risk for stroke, but recognizing it in kids is challenging and treatment is complex.
So said a group of pediatric stroke specialists who reported a series of studies today at the American Stroke Association meeting here.
In adults, they said, ischemic strokes account for 88% of all strokes while in children about half are ischemic and half are hemorrhagic.
Children with ischemic stroke have many of the same symptoms as adults-sudden onset hemiplegia, aphasia, and difficulty in walking. But in children these symptoms are often attributed to "flu or acting out," said Rebecca Ichord, M.D. director of Children's Hospital of Philadelphia.
But children also have some symptoms that are very different from those in adults. For example, pediatric symptoms include headache, sleepiness, and vomiting. Moreover, 25% to 50% of children have seizure at onset of ischemic stroke, versus about 5% of adults, she said.
Nonetheless, these symptoms, too, are often misinterpreted by both parents and physicians. And while half of parents will seek medical attention within six hours of symptoms, they usually take the ailing child to a physician's office or community hospital. More hours pass, Dr. Ichord said, before children arrive at a center such as hers.
In order to better identify the timeline in pediatric ischemic stroke, Dr. Ichord conducted a prospective consecutive case series study of children treated at her center between March 2003 and November 2004.
Twelve children-seven of them male-were included in the study. The age range was two years to 17, and the average time from onset of symptoms to presentation for medical treatment was 5.6 hours.
Although the majority of children in the study were brought to medical attention promptly after the onset of their symptoms, several experienced delays approaching 24 hours before receiving a definitive diagnosis and emergency stroke-specific treatment.