Abstract
Background
Cardiac disease is a leading cause of stroke in children, yet limited data support
the current stroke prevention and treatment recommendations. A multidisciplinary panel
of clinicians was convened in February 2014 by the International Pediatric Stroke
Study group to identify knowledge gaps and prioritize clinical research efforts for
children with cardiac disease and stroke.
Results
Significant knowledge gaps exist, including a lack of data on stroke incidence, predictors,
primary and secondary stroke prevention, hyperacute treatment, and outcome in children
with cardiac disease. Commonly used diagnostic techniques including brain computed
tomography and ultrasound have low rates of stroke detection, and diagnosis is frequently
delayed. The challenges of research studies in this population include epidemiologic
barriers to research such as small patient numbers, heterogeneity of cardiac disease,
and coexistence of multiple risk factors. Based on stroke burden and study feasibility,
studies involving mechanical circulatory support, single ventricle patients, early
stroke detection strategies, and understanding secondary stroke risk factors and prevention
are the highest research priorities over the next 5-10 years. The development of large-scale
multicenter and multispecialty collaborative research is a critical next step. The
designation of centers of expertise will assist in clinical care and research.
Conclusions
There is an urgent need for additional research to improve the quality of evidence
in guideline recommendations for cardiogenic stroke in children. Although significant
barriers to clinical research exist, multicenter and multispecialty collaboration
is an important step toward advancing clinical care and research for children with
cardiac disease and stroke.
Keywords
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Article info
Publication history
Published online: October 04, 2014
Accepted:
September 22,
2014
Received:
July 11,
2014
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
