Rebecca Ichord, MD: Challenges in Providing Care for Pediatric Stroke


The director of the Pediatric Stroke Program at CHOP spoke about the need to improve early recognition and assessments in pediatric stroke, and how ultimately, awareness of the condition is a huge step toward achieving this goal.

“The biggest challenge in childhood stroke is early recognition and then early access to high-level assessments. The ability of community hospitals to think about stroke in a child is still at a level that needs improvement.”

When a child presents to a provider with, say, an acute focal seizure followed by an acute hemiparesis—very rarely does the provider jump to the conclusion of childhood stroke. And while the approach to care in these situations has improved in the last decade, there remains a lack of attention to the possibility.

Childhood stroke is not exactly common—a 2011 review reported the incidence of combined ischemic and hemorrhagic pediatric stroke to range from 1.2 to 13 cases per 100,000 children under 18 years of age. Although, the authors of that review noted that it is likely more common than realized, as it is believed to be frequently undiagnosed or misdiagnosed.1

At the 2019 American Academy of Neurology (AAN) Annual Meeting in Philadelphia, Pennsylvania, NeurologyLive® spoke with Rebecca Ichord, MD, director, Pediatric Stroke Program, Children’s Hospital of Philadelphia (CHOP), about this topic. Ichord noted that improvements in early recognition and assessments still need to be improved and that ultimately, awareness of pediatric stroke is a huge step toward achieving this goal.

Ichord also discussed the obstacles caused by the differences between treating this in pediatric patients compared to adults, even at a hospital such as CHOP, and how these can be addressed.

For more coverage of AAN 2019, click here.


1. Tsze DS, Valente JH. Pediatric stroke: a review. Emerg Med Int. Published online December 27, 2011. doi: 10.1155/2011/734506.

2. Hutchinson M, Kimmel A, Granath C, et al. Potential eligibility for hyperacute treatment in childhood acute arterial ischemic stroke: findings from a single-center 12-year cohort study. Presented at: 2019 American Academy of Neurology Annual Meeting. May 4-10, 2019; Philadelphia, PA.

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