Zeitschrift für pädiatrische Neurologie und Medizin

A Viable Strategy in the Era of Suggested Thrombolysis for "Brain Assaults" and Acute Stroke in Children

Abstract

Melissa Shroff*

A common scenario for providers of acute pediatric care is children experiencing sudden focal neurological symptoms, also known as "brain attacks." A few will have suffered vascular strokes. An acknowledged medical emergency is a positive FAST (Face, Arms, Speech, and Time) test for adults with a suspicion of stroke. Unless they are in a coma, children rarely receive immediate care. Children face a variety of multifactorial obstacles in recognizing and responding to strokes. Stroke in children is uncommon and may be "FAST negative." In general, there is little awareness, little clinical suspicion, and a lot of logistical obstacles standing in the way of prompt detection and desired treatment delivery. However, stroke still affects hundreds of children every year in the UK, resulting in life-altering disabilities and, in some cases, death. The 2017 Royal College of Paediatrics and Child Health (RCPCH) Stroke in Childhood guideline contains current key recommendations for the diagnosis and treatment of acute stroke. The focus of this article is on those recommendations. Important practice points are provided, as well as a discussion of the evidence and rationale. In light of the proposed hyperacute management pathway, which includes thrombolysis, arterial ischaemic stroke is the focus. Consideration is given to the local obstacles that need to be overcome.