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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Roadmap for the Assessment and Management of Outcomes in Pediatric Stroke
Ryan J Felling1, Lori C Jordan2, Christine Mrakotsky3
1Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Pediatric stroke recovery involves distinct phases, from acute care to long-term rehabilitation. Standardizing assessments is crucial for optimizing treatment and improving outcomes for children with stroke.
Area of Science:
- Pediatric Neurology
- Neurorehabilitation
- Stroke Medicine
Background:
- Neurological deficits are frequent following pediatric stroke, impacting long-term educational and social functioning.
- Recovery progresses through distinct phases: hyperacute, acute, subacute, and chronic, each with specific care goals.
Purpose of the Study:
- To review the stages of recovery after pediatric stroke.
- To emphasize critical assessment time points in pediatric stroke recovery.
- To promote standardized outcome assessments for future clinical trials and optimized care.
Main Methods:
- Review of pediatric stroke recovery phases by a multidisciplinary expert group.
- Emphasis on critical assessment time points within each recovery phase.
Main Results:
- Identification of distinct phases in pediatric stroke recovery (hyperacute, acute, subacute, chronic).
- Highlighting the importance of specific assessments at critical time points during recovery.
- Recognizing the need for standardized outcome measures to compare interventions.
Conclusions:
- Standardizing outcome assessments in pediatric stroke is essential for advancing clinical trials and optimizing patient care.
- A phased approach to recovery and assessment can guide multidisciplinary care strategies.
- Improved assessment standardization will facilitate evidence-based treatment and rehabilitation for children with stroke.
Abstract:
Neurological morbidity is common after pediatric stroke, with moderate to severe deficits that can significantly impact education and social function. Care and recovery occur in phases distinguished by the time interval after stroke onset. These phases include the hyperacute and acute periods in which the focus is on cerebral reperfusion and prevention of neurological deterioration, followed by the subacute and chronic phases in which the focus is on secondary stroke prevention and mitigation of disability through rehabilitation, adaptation, and reintegration into the community. In this article, a multidisciplinary group of pediatric stroke experts review the stages of recovery after pediatric stroke with an emphasis on critical assessment time points. Our goal is to encourage increased standardization of outcome assessment to facilitate future clinical trials comparing various treatment and intervention options and advance optimized care for children with stroke.
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