Developmental medicine and child neurology
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Dev Med Child Neurol · Jul 2008
Delays in investigation and management of acute arterial ischaemic stroke in children.
The aim of this study was to investigate the timing and course of investigation and diagnosis in children with acute arterial ischaemic stroke (AIS) and factors influencing this using a retrospective case-note review. Participants comprised 50 children (26 males, 24 females; median age at presentation 3 y 4 mo, range 2 mo-16 y 10 mo). Although all had brain infarction, symptoms resolved in less than 24 hours in 21 children (transient ischaemic attack [TIA] group). ⋯ Our results show that most children with acute AIS are seen within 6 hours but definitive imaging and specialist assessment take more than 24 hours. Time to diagnosis is significantly longer in children with TIA (p=0.001). Trials of acute treatment being designed for childhood AIS will require rapid transfer to tertiary centers and access to definitive neuroimaging, but these data suggest that this will challenge existing practice.