TY - JOUR
T1 - Stroke in children with cardiac disease
T2 - Report from the international pediatric stroke study group symposium
AU - Sinclair, Adriane J.
AU - Fox, Christine K.
AU - Ichord, Rebecca N.
AU - Almond, Christopher S.
AU - Bernard, Timothy J.
AU - Beslow, Lauren A.
AU - Chan, Anthony K.C.
AU - Cheung, Michael
AU - Deveber, Gabrielle
AU - Dowling, Michael M.
AU - Friedman, Neil
AU - Giglia, Therese M.
AU - Guilliams, Kristin P.
AU - Humpl, Tilman
AU - Licht, Daniel J.
AU - Mackay, Mark T.
AU - Jordan, Lori C.
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - arterial ischemic
KW - cardiac
KW - congenital heart disease
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=84919340817&partnerID=8YFLogxK
U2 - 10.1016/j.pediatrneurol.2014.09.016
DO - 10.1016/j.pediatrneurol.2014.09.016
M3 - Review article
C2 - 25532775
AN - SCOPUS:84919340817
SN - 0887-8994
VL - 52
SP - 5
EP - 15
JO - Pediatric Neurology
JF - Pediatric Neurology
IS - 1
ER -