Research Findings

The Need for Rapid Diagnosis

Laney’s Story: The Problem of Delayed Diagnosis of Pediatric Stroke
Parent advocacy groups and collaborations of pediatric stroke specialists work to improve recognition of pediatric stroke through research, social media campaigns, and education. These groups are often born of tragedy: a patient suffers a devastating stroke, and a physician turns her efforts to champion the field while a parent rallies families to advocate for improved recognition of a shared diagnosis. In this case, the death of a bright, beautiful 4-year-old girl inspires a family to dedicate her legacy to this noblest of causes: spreading her story so that someone else’s child may live. Published by American Academy of Pediatrics, 2019

Stroke in Children: Recognizing Opportunities for Improving Care
Focused updates on stroke in children. Dr. Lori Jordan, 2019

Emergency Patient Becomes Part of Stroke Study Following Thrombectomy
From the Cleveland Clinic, 2018

VIPS II Study Homes In on Pediatric Arterial Ischemic Stroke
Better understanding of the potential etiology of recurrence risk for childhood stroke is the focus of the second Vascular Effects of Infection in Pediatric Stroke (VIPS II) study. 2018

Headache far more common stroke symptom in children than adults
Dr. Lori Billinghurst, 2017

Rapid response to kids’ stroke symptoms may speed diagnosis
American Heart Association Journal, Stroke, 2015

Kids and Strokes: Are They Little Adults After All?
Published in EMS World, Dr. Peter Antevy. “After over a decade in practice as a pediatric emergency physician and five years as an EMS medical director, I have concluded that the following two groups should treat kids like little adults: EMS, and ED physicians who treat adults.”

Newborn Dying of Stroke Survives After Doctors Perform Surgery Designed for Adults
Clot removal device that has successfully been used on adults, saved the life of a 9 day-old suffering a stroke. 2017

Pediatric Acute Stroke Protocol Activation in a Children’s Hospital Emergency Department
Pediatric acute stroke teams are a new phenomenon. This research sought to characterize the final diagnoses of children with brain attacks in the emergency department where the pediatric acute stroke protocol was activated and to describe the time to neurological evaluation and neuroimaging. American Heart Association Journal, Stroke 2015

Infection, vaccination, and childhood arterial ischemic stroke
Minor infection can trigger adult arterial ischemic stroke (AIS) and is common in childhood. They tested the hypotheses that infection transiently increases risk of AIS in children, regardless of stroke subtype, while vaccination against infection is protective. VIPS study results, Journal of the American Academy of Neurology, 2015

Emergence of the Primary Pediatric Stroke Center
In adult stroke, the advent of thrombolytic therapy led to the development of primary stroke centers capable to diagnose and treat patients with acute stroke rapidly. This describes the development of primary pediatric stroke centers through preparation of participating centers in the Thrombolysis in Pediatric Stroke (TIPS) trial. American Heart Association Journal, Stroke, 2014

Can You Recognize Stroke in the Young?
“There is still much we can do to improve the outcomes for young victims of stroke, both as part of a stroke system of care and as individual EMS providers.” Published in EMS World, 2013

Seizures Common in Pediatric Stroke
The results of this multicenter, collaborative study added to the understanding of seizure and epilepsy risk following pediatric [intracerebral hemorrhage]. 2013

The Bare Essentials for Primary Care & ED Physicians
Pediatric Stroke Care: the Bare Essentials for Primary Care and ED Physicians. Children’s Hospital of Philadelphia, 2013

Pediatric Stroke: A Review
Despite an increased incidence of pediatric stroke, there is often a delay in diagnosis, and cases may still remain under- or misdiagnosed. Understanding that children with strokes present differently than adults and often present with unique risk factors will optimize outcomes in children. From the Emergency Medicine International Journal, 2011

Early intervention after perinatal stroke: Opportunities and challenges
In contrast to the significant progress that has been made with prevention, diagnosis and management in stroke in adults, management of perinatal stroke remains problematic at each step. There are often significant delays between onset of parental concern and final diagnosis of presumed perinatal stroke, the latter reported to occur at a mean age of 12.6 months. 2014

Long-Term Outcome

Articles from the American Congress of Rehabilitation Medicine/Archives of Physical Medicine and Rehabilitation

Newborn babies who suffered stroke regain language function in opposite side of brain
Investigators found that a decade or two after a “perinatal” stroke damaged the left “language” side of the brain, affected teenagers and young adults used the right sides of their brain for language. A study led by Georgetown University Medical Center, 2018

You can change the brain even after it looks fully recovered
Research completed at the Calgary camps has led to recent publications showing that two different kinds of brain stimulation can help the brain and motor systems learn so that kids with stroke achieve better outcomes. Dr. Adam Kirton, University of Calgary, 2018

Robotic device helping young stroke survivors recover
Thousands of Canadian kids have disabilities related to strokes they suffered at birth, and now researchers believe a robot may be able to help. Dr. Adam Kirton, University of Calgary, 2016

Outcome in Childhood Stroke
Contrary to commonly held views, children do not recover better than adults after a stroke. The lifelong individual, family, and societal burden of stroke is likely to be greater than in adults because infants and children surviving stroke face many more years living with disability. American Heart Association Journal, Stroke 2016

Emerging Subspecialties in Neurology: Pediatric stroke and cerebrovascular disorders
Summary and descriptions on history and future of neurology subcategories. American Academy of Neurology, 2016

Out of Pocket Costs for Childhood Stroke: The Impact of Chronic Illness Upon Parents’ Pocketbooks
Direct costs for children who had stroke are similar to those for adults. There is no information regarding the out-of-pocket costs families encounter. They described the out-of-pocket costs families encountered in the first year after a child’s ischemic stroke. 2016

Paediatric stroke: pressing issues and promising directions
Stroke occurs across the lifespan with unique issues in the fetus, neonate, and child. The past decade has seen substantial advances in paediatric stroke research and clinical care, but many unanswered questions and controversies remain. 2015

Factors affecting cognitive outcome in early pediatric stroke
Examination of cognitive performance in children after stroke to study the influence of age at stroke, seizures, lesion characteristics, neurologic impairment, and functional outcome on cognitive outcome. 2014

Long-term outcomes of pediatric ischemic stroke in adulthood
This population-based study assesses the long-term impact of childhood stroke on function and independence in young adults. They undertook a cross-sectional outcome study of patients with arterial ischemic stroke and cerebral sinovenous thrombosis, beyond 18 years of age. 2013

Different Plasticity Patterns of Language Function in Children With Perinatal and Childhood Stroke
Plasticity of language function after brain damage can depend on maturation of the brain. Children with left-hemisphere perinatal (n = 7) or childhood stroke (n = 5) and 12 controls were investigated using functional magnetic resonance imaging. 2013

Life After Perinatal Stroke
Several fundamental gaps in the understanding of perinatal stroke outcomes are of essential clinical relevance. How can 2 children with virtually identical brain lesions acquired at the same time have extremely different outcomes? How does a child develop new skills that his or her brain has never possessed during stroke recovery? How do we measure outcome as the child continues to grow into deficits with maturation? What are the modulators of developmental plasticity that might be targeted to achieve better functional outcomes? Dr. Adam Kirton and Dr. Gabrielle deVeber 2013