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Delay or Failure to Diagnose Pediatric Strokes is Far Too Common

Did you know that pediatric stroke is one of the top 10 causes of death in children? Around 3,000 U.S. children suffer a stroke each year — that’s nearly 1 in 3,000. Children are at their highest risk for strokes very early, according to Dr. Neil Friedman, a pediatric neurologist at the Cleveland Clinic’s Center for Pediatric Neurology. While they can occur at any time, the highest risk is during late-stage pregnancy and the first week of life, with 40 to 50 percent of all pediatric strokes occurring within the first year.

With childhood stroke in that top 10 list, it may shock you to learn that the average time doctors take to recognize a childhood stroke is 28 hours. Tragically, a delay in diagnosis, or a failure to diagnose the stroke at all, can be debilitating or deadly because immediate treatment is essential.

A stroke is a problem with the blood supply to the brain. Brain arteries might be blocked by a blood clot (ischemic stroke), or trauma or malformation could cause a brain artery to burst and bleed into the brain (hemorrhagic stroke). Since blood carries oxygen to the brain, an interruption in blood flow to the brain from either type causes oxygen deprivation, which damages or kills the affected tissue.

Strokes can cause both cognitive and physical problems and unfortunately, according to Dr. Friedman, pediatricians often fail to recognize that a stroke has occurred until those deficits begin to show up.

The good news is that kids who survive strokes have a very good chance of recovery, although about 20 percent have another childhood stroke. Unfortunately, they can be hard for parents to detect in children who are too young to explain their symptoms.

The symptoms of stroke are typically an excruciating headache along with nausea and sensitivity to light — similar to those of migraines and concussions. The frequency of pediatricians’ delays in or failure to diagnose them might be due to this symptom similarity, especially if the child has been hit on the head.

Getting the immediate treatment needed for pediatric strokes may require strong advocacy on your child’s behalf. Until pediatricians and emergency medical professionals get better at recognizing strokes in children, parents may simply have to insist on answers.

Source: ABC News, “Pediatric Stroke Often Misdiagnosed, Treatment Delayed,” Susan Donaldson James. Feb. 11, 2103