Pediatric Stroke—Are We Asking the Right Questions?
The 2022 Sidney Carter Award Lecture
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Abstract
Over the past few decades, robust clinical and research collaborations among pediatric stroke researchers have informed and improved the care of children with stroke. Risk factors and presentation of childhood stroke have been described, and the acute and chronic burden of childhood stroke has been better delineated. Nevertheless, high-quality data for the treatment of children with stroke is dwarfed by that available for adult stroke, and it is therefore tempting to extend research questions and treatment trials from adults to children. A trial designed to answer a question about stroke in adults may yield useful information about stroke in childhood, but a trial that incorporates the unique neurodevelopmental and etiologic aspects of childhood stroke is more likely to truly advance care. Research questions and study design in childhood stroke must capture the complexity of stroke mechanisms and medical comorbidities in children who suffer stroke, the impact on the developing nervous system, and the role of normal and aberrant neurodevelopment in recovery.
Glossary
- AIS=
- arterial ischemic stroke;
- MTHFR=
- methylenetetrahydrofolate reductase;
- NIHSS=
- NIH Stroke Scale;
- TIPS=
- Thrombolysis in Pediatric Stroke;
- TIPSTERS=
- TIPS Extended Results Study;
- tPA=
- tissue plasminogen activator;
- VZV=
- varicella-zoster virus
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Solicited and externally peer reviewed. The handling editor was Renee Shellhaas, MD, MS.
- Received July 8, 2022.
- Accepted in final form September 14, 2022.
- © 2022 American Academy of Neurology
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Dr. Jeffrey Allen and Dr. Nicholas Purcell
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