Importance of Identifying Etiology in Pediatric Stroke: Kristin Guilliams, MD, MSCI

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The associate professor at Washington University School of Medicine provided commentary on the state of care for pediatric stroke, and the challenges with identifying the most likely etiology. [WATCH 3 minutes]

WATCH TIME: 3 minutes

"I think many of the gaps are still how to treat these children knowing that the reasons for their strokes are different than adults. Much of the talk was about the hyperacute treatment when we recognize a stroke, but even being able to ultimately take it a step further and how we can prevent a stroke from ever happening."

Although it is commonly thought of as a disease amongst the elderly, it is important to recognize the impacts of stroke in pediatric settings. Given the occurrence at a younger age, with potential long-term effects on disability, some argue stroke may be more detrimental in the pediatric population. In both populations, acute stroke management is time dependent, as earlier treatment raises the likelihood of preserving penumbra, restoring cerebral blood flow, and potentially reversing symptoms, thereby limiting disability.

Tailoring hyperacute management strategies in young patients with stroke remains a topic of conversation for neurologists. At the 2023 American Neurological Association (ANA) Annual Meeting, held September 9-12, in Philadelphia, Pennsylvania, Kristin Guilliams, MD, MSCI, gave a presentation on this subject, highlighting the various ways pediatric patients are treated. In her presentation, she noted that different institutions have different benefit analyses for thrombolysis, as some will only give the therapy in patients with confirmed ischemic stroke on MRI while others will only require high suspicion of ischemic stroke and no known risk factors.

In her presentation, Guilliams noted reasons for the controversy of thrombolysis in pediatrics, including the fact that some stroke care safety and benefit relies on the practice of systems that provide treatment relatively frequently. Guilliams, an associate professor at Washington University School of Medicine, sat down with NeurologyLive® at the meeting to discuss the current state of care for pediatric stroke, and where improvements can be made. In addition, she gave her thoughts on the challenges with determining the most likely etiology for a patient, and how the stroke may have formed.

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