3 ISC NEWS DAY 1 | WEDNESDAY, FEBRUARY 5, 2025 StrokeConference.org #ISC25 Advances in managing adult ischemic stroke have been countless. But it’s a different story in pediatric stroke, where numerous uncertainties remain. Although youth is perceived as an advantage in stroke recovery, young patients have high rates of mortality and disability, said Rachel Pearson, MD, assistant clinical professor of pediatrics at the University of California, Irvine, and pediatric neurologist at Children’s Hospital of Orange County. Pearson is among the presenters at a session Wednesday on pediatric ischemic stroke. In her presentation “Challenges and Advances in Prehospital Care for Pediatric Stroke,” she will break down uncertainties and strategies to move forward. “There is a misconception that children with stroke ‘do better’ than adults in terms of recovery,” she said. “Although this can be true in some cases, many children have persistent neurological and/or neurodevelopmental impairments that they will carry with them for a lifetime. Such stroke-related disability not only affects these children and their families but also comes with significant long-term health care costs and resource utilization.” Pearson said pediatric stroke diagnosis is often delayed because of factors including lack of awareness, frequency of stroke mimics in children, variability in clinical presentation and the need for MRI as the preferred diagnostic modality for pediatric ischemic stroke. Timely and accurate diagnosis is essential for modern stroke interventions such as thrombolysis and endovascular thrombectomy to succeed. Achieving rapid diagnosis of stroke in children starts at the first point of contact, which is often in the emergency department or a prehospital setting, Pearson said. “We first must increase awareness and knowledge of those in the community, first responders and emergency department providers,” she said. “To do this, it is critical to collaborate with local and regional partners like public health care agencies, emergency medical services and community emergency departments. In creating such partnerships, we can spread education and develop processes of care to improve pediatric stroke recognition, diagnosis and treatment.” Pearson notes a few milestones in advancing pediatric ischemic stroke knowledge and care. For example, the International Pediatric Stroke Study — a multicenter, international, longitudinal, observational study and registry of pediatric stroke patients launched in 2003 — has broadened understanding of pediatric stroke epidemiology, risk factors and outcomes. And in 2019, the American Heart Association published its scientific statement on the Navigating the Pediatric Ischemic Stroke Landscape: Innovations in Prehospital and Intrahospital Management 2-3 p.m. Wednesday, Feb. 5 Room 502B UPCOMING SESSION Pearson Sporns see PEDIATRIC, page 14 Stroke advancements in children remain a challenge Focusing on pediatric differences versus adults is critical.
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