Infant stroke severely under-recognized, researcher says

A neurologist at the University of California at San Francisco says stroke in neonates and children is severely under-recognized, with about 1 case per 4,000 live births. About 6 percent of those children will die, 20 to 35 percent will go on to have another stroke, and more than two-thirds of survivors will have neurological deficits or seizures.From the American Academy of Neurology:Neurologist Says Stroke Among Neonates and Children is Severely Under-Recognized

SAN FRANCISCO, CA ? There is a serious under-recognition of stroke in the neonate and child, and risk factors and appropriate treatment strategies remain largely unidentified, according to Donna Ferriero, MD, chief neurologist at the University of California-San Francisco Department of Neurology.

Ferriero discusses risk factors leading to stroke in neonates and children as part of an October 24 briefing for science and health care writers. “Child Neurology: Discoveries and Practice” includes seven prominent child neurologists speaking on neurological disorders affecting children. Ferriero will present two papers recently published in Neurology, the scientific journal of the American Academy of Neurology, which outline an 11-year study of sinovenous thrombosis (stroke) in neonates, and stroke mortality data in children.

Stroke in infancy and childhood occurs in one per 4000 live births and at least seven per 100,000 children a year, making these disorders more than twice as frequent as brain tumors in children, said Ferriero. Adverse outcomes include death in 6 percent, stroke recurrence in 20 to 35 percent of children, and neurological deficits or seizures in over two-thirds of survivors. Because of age-related differences only minimal research data derived from adult stroke studies, including the risks and benefits of treatments, can be extrapolated to neonates and children.

Ferriero said barriers prevent needed investigation into the cause and treatment of neonatal and childhood stroke, including:

The perception that stroke in neonates and children is exceedingly rare and therefore there isn’t a pressing need to study these populations.
Lack of awareness of neonatal and childhood stroke results in delayed and missed diagnosis, and non-standardized approaches to investigation and management in individual patients.
Neonatal stroke is especially under-diagnosed, and the timing and risk factors are difficult to determine because they may occur prenatally. It is necessary to work with obstetricians to
develop primary prevention strategies.
Most animal studies are not critically designed to test hypotheses based on stages of maturity and development as they relate to stroke mechanisms.
There are insufficient numbers of investigators trained in translational and clinical research in pediatric stroke.
The American Academy of Neurology, the AAN Education & Research Foundation, the Child Neurology Society and the Child Neurology Foundation are sponsoring the briefing.

The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. For more information about the American Academy of Neurology, visit its web site at www.aan.com.

The Child Neurology Society is a medical specialty association with 1,305 academic and practicing pediatric neurologists as members worldwide. Its mission is to ensure and maintain excellence in patient care, education, training, research and advocacy.

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