Roadmap for the Assessment and Management of Outcomes in Pediatric Stroke

Ryan J Felling; Lori C Jordan; Christine Mrakotsky; Gabrielle deVeber; Rachel K Peterson; Aleksandra Mineyko; Samantha J Feldman; Kevin Shapiro; Warren Lo; Lauren A Beslow

doi:10.1016/j.pediatrneurol.2023.01.008

Roadmap for the Assessment and Management of Outcomes in Pediatric Stroke

Pediatr Neurol. 2023 Apr:141:93-100. doi: 10.1016/j.pediatrneurol.2023.01.008. Epub 2023 Jan 20.

Authors

Affiliations

¹ Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: rfelling@jhmi.edu.
² Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
³ Departments of Psychiatry & Neurology, Center for Neuropsychology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
⁴ Child Health Evaluative Sciences Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
⁵ Neuropsychology Department, Kennedy Krieger Institute, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland.
⁶ Section of Neurology, Department of Pediatrics, University of Calgary, Alberta, Canada.
⁷ Neurosciences and Mental Health Research Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
⁸ Cortica Healthcare, Westlake Village, California; Division of Neurology, Children's Hospital Lost Angeles, Los Angeles, California.
⁹ Departments of Pediatrics and Neurology, The Ohio State University Nationwide Children's Hospital, Columbus, Ohio.
¹⁰ Division of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

PMID: 36805967
PMCID: PMC11439373
DOI: 10.1016/j.pediatrneurol.2023.01.008

Abstract

Neurological morbidity is common after pediatric stroke, with moderate to severe deficits that can significantly impact education and social function. Care and recovery occur in phases distinguished by the time interval after stroke onset. These phases include the hyperacute and acute periods in which the focus is on cerebral reperfusion and prevention of neurological deterioration, followed by the subacute and chronic phases in which the focus is on secondary stroke prevention and mitigation of disability through rehabilitation, adaptation, and reintegration into the community. In this article, a multidisciplinary group of pediatric stroke experts review the stages of recovery after pediatric stroke with an emphasis on critical assessment time points. Our goal is to encourage increased standardization of outcome assessment to facilitate future clinical trials comparing various treatment and intervention options and advance optimized care for children with stroke.

Keywords: Brain injury; Child; Ischemia; Recovery; Rehabilitation.

Publication types

Review

MeSH terms

Child
Humans
Outcome Assessment, Health Care
Stroke Rehabilitation*
Stroke* / diagnosis
Stroke* / therapy

Grants and funding

K24 HL147017/HL/NHLBI NIH HHS/United States