Childhood Stroke: Approach to Hyperacute Management and Indications for Recanalization Therapies*

Date/Time: Monday, September 11, 2023 - 12:00 PM – 1:00 PM
Track: Interactive Lunch Workshop
Room: Franklin Hall 4 (4th Floor)
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Chair: Mark Wainwright, MD, PhD, FANA

Co-Chair: Kristin Guilliams, MD, MSCI

Acute management of children with arterial ischemic stroke is hampered by the many stroke mimics in children, delay in diagnosis, heterogenous etiologies of stroke, and the limited evidence for safe and effective treatments. While mechanical and pharmacologic treatment recanalization treatment strategies have shown benefit in adults with stroke, evidence is lacking for children. As a result, most decisions about these interventions need to be individualized to each child’s case. However, many children or adolescents may present to centers where are there is limited pediatric neurology expertise and acute treatment decisions need to be made by adult neurologists.

This session will review recent trends in acute interventions for treatment of stroke in the young, evidence for the use of endovascular treatment, and the approach to patient selection for such treatment along hyperacute management of stroke in the young. 

Learning Objectives:

  • To become familiar with the risk factors for stroke in the young and trends in acute management.
  • To understand the indications for acute recanalization therapies in children with stroke.

Epidemiology and causes of stroke in the young: trends in acute intervention

Speaker: Fadar Otite, MD, ScM

This session will (1) Explore contemporary data on the epidemiology of acute ischemic stroke in children and young adults, (2) Compare and contrast the  leading causes of ischemic stroke in children versus young adults (3) Evaluate current data on the utilization of acute ischemic stroke recanalization treatment modalities in children (4)Describe trends in the utilization of acute recanalization modalities in children and young adults.

Tailored hyperacute management of stroke in the young; individualizing management strategies and selecting patients for recanalization

Speaker: Kristin Guilliam, MD, MSCI

Recent trials have expanded ischemic stroke treatment options and time windows in recent years, but have overwhelmingly been limited to stroke patients 18 years or older. Pediatric stroke awareness is increasing, leading to sooner presentation and recognition of childhood stroke, many of whom may be within a time window for potential treatment. In this session, we will review recent data from childhood and adult stroke and discuss balancing when it may or may not be reasonable to extrapolate adult stroke management to childhood stroke.