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
N1 - Publisher Copyright:
© 2019 Japan Pediatric Society
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.
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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 -