The Journal of Pediatrics
Volume 154, Issue 5 , Pages 727-732.e1 , May 2009

Pediatric Stroke: Do Clinical Factors Predict Delays in Presentation?

  • Adam L. Hartman, MD

      Affiliations

    • Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD
    • Corresponding Author InformationReprint requests: Adam L. Hartman, MD, Johns Hopkins Hospital, Department of Neurology, 600 N Wolfe Street, Meyer 2-147, Baltimore, MD 21287
  • ,
  • Kevin M. Lunney, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
  • ,
  • Jacqueline E. Serena, MD

      Affiliations

    • Department of Pediatrics, Naval Medical Center San Diego, San Diego, CA

Received 5 June 2008 ,Revised 29 September 2008 ,Accepted 5 November 2008.

References 

  1. Riela AR, Roach ES. Etiology of stroke in children. J Child Neurol. 1993;8:201–220
  2. Shellhaas RA, Smith SE, O'Tool E, Licht DJ, Ichord RN. Mimics of childhood stroke: characteristics of a prospective cohort. Pediatrics. 2006;118:704–709
  3. Katzan IL, Hammer MD, Hixson ED, Furlan AJ, Abou-Chebl A, Nadzam DM. Cleveland Clinic Health System Stroke Quality Improvement Team (Utilization of intravenous tissue plasminogen activator for acute ischemic stroke). Arch Neurol. 2004;61:346–350
  4. Gabis LV, Yangala R, Lenn NJ. Time lag to diagnosis of stroke in children. Pediatrics. 2002;110:924–928
  5. Braun KP, Kappelle LJ, Kirkham FJ, Deveber G. Diagnostic pitfalls in paediatric ischaemic stroke. Dev Med Child Neurol. 2006;48:985–990
  6. Lynch JK, Hirtz DG, DeVeber G, Nelson KB. Report of the National Institute of Neurological Disorders and Stroke workshop on perinatal and childhood stroke. Pediatrics. 2002;109:116–123
  7. Zimmer JA, Garg BP, Williams LS, Golomb MR. Age-related variation in presenting signs of childhood arterial ischemic stroke. Pediatr Neurol. 2007;37:171–175
  8. Broderick J, Talbot GT, Prenger E, Leach A, Brott T. Stroke in children within a major metropolitan area: the surprising importance of intracerebral hemorrhage. J Child Neurol. 1993;8:250–255
  9. Earley CJ, Kittner SJ, Feeser BR, Gardner J, Epstein A, Wozniak MA, et al. Stroke in children and sickle-cell disease: Baltimore-Washington Cooperative Young Stroke Study. Neurology. 1998;51:169–176
  10. State of California, Department of Finance. c2007 [cited 30 Dec 2004]. http://www.dof.ca.gov/html/Demograp/DRU_datafiles/Race/RaceData_90-99/1999.csvAccessed December 30, 2004
  11. National Institute of Neurological Disorders and Stroke (Special report: classification of cerebrovascular diseases III). Stroke. 1990;21:637–676
  12. Qureshi AI, Kirmani JF, Sayed MA, Safdar A, Ahmed S, Ferguson R, et al. ; Buffalo Metropolitan Area and Erie County Stroke Study Group (Time to hospital arrival, use of thrombolytics, and in-hospital outcomes in ischemic stroke). Neurology. 2005;64:2115–2120
  13. Goldstein LB, Edwards MG, Wood DP. Delay between stroke onset and emergency department evaluation. Neuroepidemiology. 2001;20:196–200
  14. Yip PK, Jeng JS, Lu CJ. Hospital arrival time after onset of different types of stroke in Greater Taipei. J Formos Med Assoc. 2000;99:532–537
  15. Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975;1:480–484
  16. Jorgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS. Factors delaying hospital admission in acute stroke: the Copenhagen Stroke Study. Neurology. 1996;47:383–387
  17. Dávalos A, Castillo J, Martinez-Vila E Cerebrovascular Diseases Study Group of the Spanish Society of Neurology. Delay in neurological attention and stroke outcome. Stroke. 1995;26:2233–2237
  18. Schoenberg BS, Mellinger JF, Schoenberg DG. Cerebrovascular disease in infants and children: a study of incidence, clinical features, and survival. Neurology. 1978;28:763–768
  19. Fullerton HJ, Wu YW, Zhao S, Johnston SC. Risk of stroke in children: ethnic and gender disparities. Neurology. 2003;61:189–194
  20. Bowen MD, Burak CR, Barron TF. Childhood ischemic stroke in a nonurban population. J Child Neurol. 2005;20:194–197
  21. Benesch C, Witter DM, Wilder AL, Duncan PW, Samsa GP, Matchar DB. Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology. 1997;49:660–664
  22. Golomb MR, Garg BP, Saha C, Williams LS. Accuracy and yield of ICD-9 codes for identifying children with ischemic stroke. Neurology. 2006;67:2053–2055
  23. Fullerton HJ, Wu YW, Sidney S, Johnston SC. Risk of recurrent childhood arterial ischemic stroke in a population-based cohort: the importance of cerebrovascular imaging. Pediatrics. 2007;11:495–501
  24. Labiche LA, Chan W, Saldin KR, Morgenstern LB. Sex and acute stroke presentation. Ann Emerg Med. 2002;40:453–460
  25. Kleindorfer DO, Miller R, Moomaw CJ, Alwell K, Broderick JP, Khoury J, et al. Designing a message for public education regarding stroke: does FAST capture enough stroke?. Stroke. 2007;38:2864–2868
  26. Rosamond WD, Reeves MJ, Johnson A, Evenson KR. Paul Coverdell National Acute Stroke Registry Prototype Investigators (Documentation of stroke onset time: challenges and recommendations). Am J Prev Med. 2006;31(6 Suppl 2):S230–S234
  27. Clancy RR, McGaurn SA, Goin JE, Hirtz DG, Norwood WI, Gaynor JW, et al. Allopurinol neurocardiac protection trial in infants undergoing heart surgery using deep hypothermic circulatory arrest. Pediatrics. 2001;108:61–70

 Supported by Neurological Sciences Academic Development Award K12NS001696 (to A.H.). The opinions or assertions contained herein are those of the authors and are not to be construed as official or reflecting the views of the Department of the Navy, Department of Defense, or the United States Government. The authors declare no conflicts of interest.

PII: S0022-3476(08)00978-5

doi: 10.1016/j.jpeds.2008.11.011

The Journal of Pediatrics
Volume 154, Issue 5 , Pages 727-732.e1 , May 2009