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Pediatric stroke: do clinical factors predict delays in presentation?

Adam L Hartman1, Kevin M Lunney, Jacqueline E Serena

  • 1Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. ahartma2@jhmi.edu

The Journal of Pediatrics
|December 30, 2008
PubMed

Insights

Delayed diagnosis of pediatric arterial ischemic stroke is common, with most children not presenting within 24 hours. Early recognition of stroke symptoms in children remains crucial for improved outcomes.

Area of Science:

  • Pediatric Neurology
  • Neuroscience
  • Public Health

Background:

  • Arterial ischemic stroke (AIS) in children is a significant cause of long-term disability.
  • Timely diagnosis and treatment are critical for improving outcomes in pediatric AIS.
  • Factors influencing delayed diagnosis in pediatric AIS require further investigation.

Purpose of the Study:

  • To investigate associations between patient age, clinical presentation, or predisposing conditions and delayed diagnosis of arterial ischemic stroke in children.
  • To identify potential factors contributing to delayed medical evaluation for pediatric AIS.

Main Methods:

  • Retrospective chart review of children admitted to tertiary care medical centers in San Diego County between 1995 and 2000.
  • Inpatient charts were screened using ICD-9 codes for stroke, cerebrovascular anomalies, hemiplegia, and migraine.

Main Results:

  • Time of presentation for medical evaluation did not differ significantly by age group, clinical presentation, or identified risk factors.
  • Only 24% of pediatric AIS patients presented within 6 hours of symptom onset, and 41% presented within 24 hours.
  • Children presenting with altered mental status had a higher mortality risk (OR=9.94), while those with hemiparesis had no deaths (P=.01).

Conclusions:

  • The study found no relationship between time of presentation and the clinical factors examined.
  • Delayed diagnosis of pediatric AIS is a significant concern, highlighting the need for increased awareness.
  • Early recognition of stroke symptoms in children is a critical goal for families and healthcare providers to improve patient outcomes.
Abstract

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