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Multicentric Pediatric Stroke Code: Insight to the first years after implementation

Ana Jové-Blanco1, José Antonio Ruiz Domínguez2, Aranzazu Flavia González-Posada Flores3

  • 1Pediatric Emergency Department, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|October 18, 2024
PubMed

Insights

A multicentric Pediatric Stroke Code (PSC) effectively diagnosed pediatric stroke, mirroring results from single-center protocols. Key indicators like altered consciousness and neurological deficits helped differentiate stroke from mimics in children.

Area of Science:

  • Pediatric Neurology
  • Emergency Medicine
  • Stroke Research

Background:

  • Unicentric pediatric acute stroke protocols have improved stroke care.
  • The effectiveness of multicentric Pediatric Stroke Codes (PSCs) was previously unestablished.

Purpose of the Study:

  • To characterize multicentric PSC activations in children.
  • To identify clinical features distinguishing stroke from stroke mimics.
  • To compare multicentric PSC outcomes with unicentric data.

Main Methods:

  • Retrospective, observational, multicentric study in Madrid's Pediatric Emergency Departments (2019-2022).
  • Included children (28 days-16 years) with activated PSC.
  • Logistic regression analyzed associations between clinical features and stroke diagnosis.

Main Results:

  • 196 PSC activations; 19.9% confirmed stroke (10.2% ischemic, 9.7% hemorrhagic).
  • Stroke mimics (80.1%) were more common, with migraine being the most frequent.
  • Low consciousness, focal neurological deficits, aphasia, and altered mental status significantly increased stroke probability.

Conclusions:

  • Multicentric PSCs are feasible and achieve results comparable to unicentric protocols.
  • This organization facilitates efficient pediatric stroke diagnosis and treatment.
Abstract

Keywords:
Brain imagingChildrenEmergency serviceStrokeStroke mimics

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