Delayed recognition of childhood arterial ischemic stroke

Ikumi Hori, Takeshi Tsuji, Misa Miyake, Kazuto Ueda, Erina Kataoka, Michio Suzuki, Satoru Kobayashi, Hirokazu Kurahashi, Yoshiyuki Takahashi, Akihisa Okumura, Tetsushi Yoshikawa, Shinji Saitoh, Jun Natsume

Research output: Contribution to journalArticle

Abstract

Background: Few population-based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population-based cohort in Japan. Methods: Children aged 29 days–15 years 11 months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010–2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7 years 3 months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated. Results: The most common presentation was paralysis or paresis in 27 patients (71%). No underlying disorders or possible trigger factors were identified in 14 patients (35%). The median time from symptom onset to first physician assessment was 2.9 h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0 h. The diagnosis of AIS was made in the first 6 h after onset of symptoms in 27% of patients for whom the time was available. Radiological diagnosis took longer than 24 h in 54% of these patients. Conclusions: Long in-hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.

Original languageEnglish
Pages (from-to)895-903
Number of pages9
JournalPediatrics International
Volume61
Issue number9
DOIs
Publication statusPublished - 01-09-2019

Fingerprint

Stroke
Physicians
Japan
Paresis
Paralysis
Population
Early Diagnosis

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Hori, I., Tsuji, T., Miyake, M., Ueda, K., Kataoka, E., Suzuki, M., ... Natsume, J. (2019). Delayed recognition of childhood arterial ischemic stroke. Pediatrics International, 61(9), 895-903. https://doi.org/10.1111/ped.13966
Hori, Ikumi ; Tsuji, Takeshi ; Miyake, Misa ; Ueda, Kazuto ; Kataoka, Erina ; Suzuki, Michio ; Kobayashi, Satoru ; Kurahashi, Hirokazu ; Takahashi, Yoshiyuki ; Okumura, Akihisa ; Yoshikawa, Tetsushi ; Saitoh, Shinji ; Natsume, Jun. / Delayed recognition of childhood arterial ischemic stroke. In: Pediatrics International. 2019 ; Vol. 61, No. 9. pp. 895-903.
@article{50407efd2d6a496ea059b95853142bb4,
title = "Delayed recognition of childhood arterial ischemic stroke",
abstract = "Background: Few population-based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population-based cohort in Japan. Methods: Children aged 29 days–15 years 11 months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010–2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7 years 3 months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated. Results: The most common presentation was paralysis or paresis in 27 patients (71{\%}). No underlying disorders or possible trigger factors were identified in 14 patients (35{\%}). The median time from symptom onset to first physician assessment was 2.9 h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0 h. The diagnosis of AIS was made in the first 6 h after onset of symptoms in 27{\%} of patients for whom the time was available. Radiological diagnosis took longer than 24 h in 54{\%} of these patients. Conclusions: Long in-hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.",
author = "Ikumi Hori and Takeshi Tsuji and Misa Miyake and Kazuto Ueda and Erina Kataoka and Michio Suzuki and Satoru Kobayashi and Hirokazu Kurahashi and Yoshiyuki Takahashi and Akihisa Okumura and Tetsushi Yoshikawa and Shinji Saitoh and Jun Natsume",
year = "2019",
month = "9",
day = "1",
doi = "10.1111/ped.13966",
language = "English",
volume = "61",
pages = "895--903",
journal = "Pediatrics International",
issn = "1328-8067",
publisher = "Wiley-Blackwell",
number = "9",

}

Hori, I, Tsuji, T, Miyake, M, Ueda, K, Kataoka, E, Suzuki, M, Kobayashi, S, Kurahashi, H, Takahashi, Y, Okumura, A, Yoshikawa, T, Saitoh, S & Natsume, J 2019, 'Delayed recognition of childhood arterial ischemic stroke', Pediatrics International, vol. 61, no. 9, pp. 895-903. https://doi.org/10.1111/ped.13966

Delayed recognition of childhood arterial ischemic stroke. / Hori, Ikumi; Tsuji, Takeshi; Miyake, Misa; Ueda, Kazuto; Kataoka, Erina; Suzuki, Michio; Kobayashi, Satoru; Kurahashi, Hirokazu; Takahashi, Yoshiyuki; Okumura, Akihisa; Yoshikawa, Tetsushi; Saitoh, Shinji; Natsume, Jun.

In: Pediatrics International, Vol. 61, No. 9, 01.09.2019, p. 895-903.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Delayed recognition of childhood arterial ischemic stroke

AU - Hori, Ikumi

AU - Tsuji, Takeshi

AU - Miyake, Misa

AU - Ueda, Kazuto

AU - Kataoka, Erina

AU - Suzuki, Michio

AU - Kobayashi, Satoru

AU - Kurahashi, Hirokazu

AU - Takahashi, Yoshiyuki

AU - Okumura, Akihisa

AU - Yoshikawa, Tetsushi

AU - Saitoh, Shinji

AU - Natsume, Jun

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: Few population-based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population-based cohort in Japan. Methods: Children aged 29 days–15 years 11 months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010–2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7 years 3 months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated. Results: The most common presentation was paralysis or paresis in 27 patients (71%). No underlying disorders or possible trigger factors were identified in 14 patients (35%). The median time from symptom onset to first physician assessment was 2.9 h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0 h. The diagnosis of AIS was made in the first 6 h after onset of symptoms in 27% of patients for whom the time was available. Radiological diagnosis took longer than 24 h in 54% of these patients. Conclusions: Long in-hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.

AB - Background: Few population-based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population-based cohort in Japan. Methods: Children aged 29 days–15 years 11 months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010–2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7 years 3 months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated. Results: The most common presentation was paralysis or paresis in 27 patients (71%). No underlying disorders or possible trigger factors were identified in 14 patients (35%). The median time from symptom onset to first physician assessment was 2.9 h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0 h. The diagnosis of AIS was made in the first 6 h after onset of symptoms in 27% of patients for whom the time was available. Radiological diagnosis took longer than 24 h in 54% of these patients. Conclusions: Long in-hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.

UR - http://www.scopus.com/inward/record.url?scp=85072746412&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072746412&partnerID=8YFLogxK

U2 - 10.1111/ped.13966

DO - 10.1111/ped.13966

M3 - Article

C2 - 31295764

AN - SCOPUS:85072746412

VL - 61

SP - 895

EP - 903

JO - Pediatrics International

JF - Pediatrics International

SN - 1328-8067

IS - 9

ER -

Hori I, Tsuji T, Miyake M, Ueda K, Kataoka E, Suzuki M et al. Delayed recognition of childhood arterial ischemic stroke. Pediatrics International. 2019 Sep 1;61(9):895-903. https://doi.org/10.1111/ped.13966