Stroke in children with cardiac disease: Report from the international pediatric stroke study group symposium

Adriane J. Sinclair, Christine K. Fox, Rebecca N. Ichord, Christopher S. Almond, Timothy J. Bernard, Lauren A. Beslow, Anthony K C Chan, Michael Cheung, Gabrielle Deveber, Michael M. Dowling, Neil Friedman, Therese M. Giglia, Kristin P. Guilliams, Tilman Humpl, Daniel J. Licht, Mark T. Mackay, Lori C. Jordan

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background Cardiac disease is a leading cause of stroke in children, yet limited data support the current stroke prevention and treatment recommendations. A multidisciplinary panel of clinicians was convened in February 2014 by the International Pediatric Stroke Study group to identify knowledge gaps and prioritize clinical research efforts for children with cardiac disease and stroke. Results Significant knowledge gaps exist, including a lack of data on stroke incidence, predictors, primary and secondary stroke prevention, hyperacute treatment, and outcome in children with cardiac disease. Commonly used diagnostic techniques including brain computed tomography and ultrasound have low rates of stroke detection, and diagnosis is frequently delayed. The challenges of research studies in this population include epidemiologic barriers to research such as small patient numbers, heterogeneity of cardiac disease, and coexistence of multiple risk factors. Based on stroke burden and study feasibility, studies involving mechanical circulatory support, single ventricle patients, early stroke detection strategies, and understanding secondary stroke risk factors and prevention are the highest research priorities over the next 5-10 years. The development of large-scale multicenter and multispecialty collaborative research is a critical next step. The designation of centers of expertise will assist in clinical care and research. Conclusions There is an urgent need for additional research to improve the quality of evidence in guideline recommendations for cardiogenic stroke in children. Although significant barriers to clinical research exist, multicenter and multispecialty collaboration is an important step toward advancing clinical care and research for children with cardiac disease and stroke.

Original languageEnglish (US)
Pages (from-to)5-15
Number of pages11
JournalPediatric Neurology
Volume52
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

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Keywords

  • arterial ischemic
  • cardiac
  • congenital heart disease
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology

Cite this

Sinclair, A. J., Fox, C. K., Ichord, R. N., Almond, C. S., Bernard, T. J., Beslow, L. A., ... Jordan, L. C. (2015). Stroke in children with cardiac disease: Report from the international pediatric stroke study group symposium. Pediatric Neurology, 52(1), 5-15. https://doi.org/10.1016/j.pediatrneurol.2014.09.016