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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Acute StrokeTreatment in Children: Are Adult Guidelines Applicable?
Sudeepta Dandapat1, Waldo R Guerrero2, Santiago Ortega-Gutierrez3
1Department of Neurosciences, Aurora Neuroscience Innovation Institute, St.Luke's Hospital, Milwaukee, WI.
Insights
Acute stroke treatments for adults are being adapted for children. Advances in imaging and therapies like endovascular therapy aim to improve outcomes for pediatric arterial ischemic stroke, a significant cause of childhood disability.
Area of Science:
- Pediatric Neurology
- Cerebrovascular Diseases
- Acute Stroke Management
Background:
- Pediatric arterial ischemic stroke (AIS) is a critical cause of long-term disability and mortality in children.
- Diagnosing and treating pediatric AIS presents unique age-dependent challenges compared to adults.
- Recent advancements in diagnostic imaging and acute stroke interventions are improving management.
Purpose of the Study:
- To review current acute stroke treatments established in adults for their applicability in pediatric populations.
- To highlight advancements in hyperacute stroke therapies for children.
- To emphasize the importance of understanding pediatric stroke for better patient outcomes.
Main Methods:
- Review of existing literature on adult acute stroke treatments.
- Analysis of applicability and adaptation of these treatments for pediatric patients.
- Discussion of recent advancements in pediatric stroke diagnosis and management.
Main Results:
- Adult acute stroke treatments are increasingly being evaluated and applied to pediatric cases.
- Hyperacute treatments, including endovascular therapy, show promise for improving pediatric stroke outcomes.
- Improved diagnostic tools and expanded treatment windows enhance the management of pediatric arterial ischemic disease.
Conclusions:
- Adapting adult stroke protocols and validating pediatric-specific pathways are crucial for advancing acute stroke care in children.
- Early and effective intervention is vital, given the potentially greater lifelong burden of disability in pediatric stroke survivors.
- Knowledge of available medical and therapeutic options is essential for managing this unique patient population.
Purpose Of This Review:
This article provides an overview into acute treatments in stroke which are widely studied and available for adults and their applicability in the pediatric population.
Recent Findings:
Arterial ischemic stroke is an important cause of morbidity and mortality in the pediatric population. Neurological deficits and etiologies are age-dependent and more challenging to diagnose than in the adult population. Advancements in imaging and treatment modalities including increased treatment windows in acute stroke have led to improvement in the diagnosis and management of pediatric arterial ischemic disease. Accordingly, hyperacute treatments, such as endovascular therapy, are becoming increasingly available in an attempt to improve outcomes in children.
Summary:
Significant scientific and technological advances have transformed the hyperacute treatment of stroke in the recent years, allowing for improvement in the diagnosis and treatment of cerebrovascular pathologies in children. Optimization in the approach, and validation of existing stroke pathways/protocols is expected to further advance acute stroke therapy in pediatric patient care. Given that the lifelong individual, family, and societal burden of acute stroke is likely to be greater than in adults because infants and children surviving stroke live more years with disability, we must be knowledgeable about this pathology and the medical and therapeutic options available for this unique population as detailed in this review.
