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Published on: April 21, 2017
Polish recommendations for diagnosis and therapy of paediatric stroke
Ewa Pilarska1, Ilona Kopyta2, Edyta Szurowska3
1Department of Developmental Neurology, Department of Neurology, Medical University of Gdansk, Gdansk, Poland. ewa.pilarska@gumed.edu.pl.
Insights
Diagnosing paediatric ischaemic arterial stroke (PAIS) is often delayed due to limited neuroimaging access and awareness. This article provides management recommendations tailored for Polish healthcare, emphasizing that stroke can occur in children.
Area of Science:
- Neurology
- Paediatrics
- Vascular Medicine
Background:
- Stroke is a significant global health challenge, causing high mortality and disability.
- Paediatric ischaemic arterial stroke (PAIS) presents unique challenges, including delayed diagnosis and different risk factors compared to adults.
- Lack of access to neuroimaging under general anaesthesia and insufficient public awareness contribute to delayed PAIS diagnosis.
Purpose of the Study:
- To develop evidence-based recommendations for managing children with acute neurological symptoms suggestive of ischaemic stroke.
- To provide guidelines for post-diagnosis treatment of paediatric ischaemic stroke.
- To adapt global stroke management guidelines to the specific needs and resources available in Poland.
Main Methods:
- The recommendations were developed by a multidisciplinary team including paediatric neurologists, neurologists, paediatric cardiologists, paediatric haematologists, and radiologists.
- The process involved reviewing current global recommendations for paediatric stroke management.
- Guidelines were tailored to match Poland's technical diagnostic and therapeutic capabilities.
Main Results:
- The article presents comprehensive recommendations for the acute management and subsequent treatment of paediatric ischaemic stroke.
- It highlights the importance of multidisciplinary collaboration in diagnosing and managing PAIS.
- The recommendations aim to improve diagnostic timeliness and treatment effectiveness for children with stroke.
Conclusions:
- Paediatric age does not exclude a stroke diagnosis; parents and caregivers must be aware of stroke symptoms in children.
- Timely diagnosis and appropriate management are crucial for improving outcomes in paediatric ischaemic arterial stroke.
- The developed recommendations provide a framework for standardized care in Poland, addressing the multifactorial nature of paediatric stroke.
Abstract:
Stroke remains one of the greatest health challenges worldwide, due to a high mortality rate and, despite great progress in its treatment, the significant disability that it causes. Studies conducted around the world show that the diagnosis of stroke in children is often significantly delayed. Paediatric ischaemic arterial stroke (PAIS) is not only a problem that varies greatly in frequency compared to the adult population, it is also completely different in terms of its risk factors, clinical course and outcome. The main reason for the lack of a rapid diagnosis of PAIS is a lack of access to neuroimaging under general anaesthesia. The insufficient knowledge regarding PAIS in society as a whole is also of great importance. Parents and carers of children should always bear in mind that paediatric age is not a factor that excludes a diagnosis of stroke. The aim of this article was to develop recommendations for the management of children with acute neurological symptoms suspected of ischaemic stroke and further treatment after confirmation of the ischaemic aetiology of the problem. These recommendations are based on current global recommendations for the management of children with stroke, but our goal was also to match them as closely as possible to the needs and technical diagnostic and therapeutic possibilities encountered in Poland. Due to the multifactorial problem of stroke in children, not only paediatric neurologists but also a neurologist, a paediatric cardiologist, a paediatric haematologist and a radiologist took part in the preparation of these recommendations.
