Published online before print December 1, 2005, doi: 10.1161/01.STR.0000191768.82730.11
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(Stroke. 2006;37:3.)
© 2006 American Heart Association, Inc.
Editorial |
The Emerging Quandary of Childhood Stoke
Better Aim but No Magic Bullet
From the Departments of Neurology and Pediatrics, University of California San Francisco
Correspondence to Heather J. Fullerton, 505 Parnassus Ave, Box 0137 San Francisco, CA 94143-0137. E-mail fullertonh@neuropeds.ucsf.edu
Key Words: pediatric stroke
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
See related article, pages 116–122.
Recent advances in the detection of childhood stroke—thanks in large part to the development of noninvasive, low risk neuroimaging—have increasingly put us in the uncomfortable position of diagnosing a stroke in a child but having little idea of what we should do about it. Although new data on stroke recurrence rates in children—as high as 22% despite "best medical management"—have raised our level of alarm,1 advances in our understanding of the etiologies of childhood stroke have made it increasingly clear that we cannot simply extrapolate secondary stroke prevention strategies from adult studies. Outside of the setting of sickle cell disease, we suffer a profound lack of evidence to guide us.
In this issue of Stroke, the providers of the 1-800-NOCLOTS service clearly demonstrate the extent of this crisis in childhood stroke management by presenting their decade of experience performing free telephone consultation to physicians caring for children with ischemic stroke.2 This extraordinary service was initiated in 1994 by the late Dr Maureen Andrews, eminent pediatric hematologist at the Hospital for Sick Children in Toronto. Having fielded phone calls on more than a thousand children with strokes, the authors conservatively estimate that, in the past 7 years, they consulted on 
8% of incident childhood strokes in the US.
This number alone reflects the tremendous uncertainty on the part of clinicians when faced with the management of a childhood stroke. Their data also suggest that although clinicians are largely comfortable with the etiologic work-up of
Related Article:
Stroke 2006 37: 116-122.
This article has been cited by other articles:
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  W. Lo, K. Zamel, K. Ponnappa, A. Allen, D. Chisolm, M. Tang, B. Kerlin, and K. O. Yeates The Cost of Pediatric Stroke Care and Rehabilitation Stroke, January 1, 2008; 39(1): 161 - 165. [Abstract] [Full Text] [PDF]
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