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Childhood Stroke: Awareness, Interest, and Knowledge Among the Pediatric Community
Michaela V Bonfert1, Katharina Badura1,2, Julia Gerstl1,3
1Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany.
Insights
Pediatricians show awareness of childhood stroke, but knowledge gaps persist. Enhanced training and multi-modal educational approaches are recommended to improve care for pediatric stroke patients.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
- Public Health
Background:
- Acute childhood stroke is a medical emergency requiring high awareness among healthcare providers.
- German pediatricians' awareness, interest, and knowledge of childhood stroke are assessed.
Purpose of the Study:
- To evaluate the current understanding and practices of German pediatricians regarding childhood stroke.
- To identify areas for improvement in the diagnosis and management of pediatric stroke.
Main Methods:
- An online survey was distributed to 1697 pediatricians in Bavaria, Germany.
- The survey assessed awareness, diagnostic considerations, symptom recognition, mimic conditions, diagnostic tools, and therapeutic strategies for childhood stroke.
Main Results:
- A 14% participation rate was achieved. 46% considered childhood stroke diagnosis in the past year, and 47% cared for affected patients.
- Recognition of the FAST (Face-Arm-Speech-Time-Test) acronym was low (27%). Common symptoms included hemiparesis (90%) and speech disorder (58%).
- Pediatricians favored MRI (96%) for diagnosis and thrombolysis (80%) for treatment. 93% desired further training, preferring sessions (80%) and publications (43%).
Conclusions:
- Childhood stroke is clinically significant for pediatricians, with considerable existing knowledge but room for enhancement.
- A multi-modal educational strategy, including training, publications, and web-based resources, is crucial.
- Optimizing pediatric stroke care requires enhanced provider education and public awareness campaigns.
Abstract:
Objective: Acute childhood stroke is an emergency requiring a high level of awareness among first-line healthcare providers. This survey serves as an indicator of the awareness of, the interest in, and knowledge of childhood stroke of German pediatricians. Methods: Thousand six hundred and ninety-seven physicians of pediatric in- and outpatient facilities in Bavaria, Germany, were invited via email to an online-survey about childhood stroke. Results: The overall participation rate was 14%. Forty-six percent of participants considered a diagnosis of childhood stroke at least once during the past year, and 47% provide care for patients who have suffered childhood stroke. The acronym FAST (Face-Arm-Speech-Time-Test) was correctly cited in 27% of the questionnaires. Most commonly quoted symptoms of childhood stroke were hemiparesis (90%), speech disorder (58%), seizure (44%), headache (40%), and impaired consciousness (33%). Migraine (63%), seizure (39%), and infections of the brain (31%) were most frequently named as stroke mimics. Main diagnostic measures indicated were magnetic resonance imaging (MRI) (96%) and computer tomography (CT) (55%). Main therapeutic strategies were thrombolysis (80%), anticoagulation (41%), neuroprotective measures, and thrombectomies (15% each). Thirty-nine percent of participants had taken part in training sessions, 61% studied literature, 37% discussed with colleagues, and 25% performed internet research on childhood stroke. Ninety-three percent of participants approve skill enhancement, favoring training sessions (80%), publications (43%), and web based offers (35%). Consent for offering a flyer on the topic to caregivers in facilities was given in 49%. Conclusion: Childhood stroke constitutes a topic of clinical importance to pediatricians. Participants demonstrate a considerable level of comprehension concerning the subject, but room for improvement remains. A multi-modal approach encompassing an elaborate training program, regular educational publications in professional journals, and web based offers could reach a broad range of health care providers. Paired with a public adult and childhood stroke awareness campaign, these efforts could contribute to optimize the care for children suffering from stroke.
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