FV 561. Childhood Stroke: Awareness, Interest and Knowledge among the Pediatric Community

Background: Acute childhood stroke is a neuropediatric emergency requiring a high level of awareness among first-line health care providers. However, the diagnosis of acute stroke is delayed in a considerable number of children. A low rate of suspicion of childhood stroke among health care providers is assumed to be one of the key issues. Therefore, educational interventions to raise the awareness of childhood stroke are necessary.

Aims and Question: The successful implementation of educational interventions is based on a prior demand analysis. This survey aimed to assess the professional awareness and knowledge of childhood stroke as well as the commitment of pediatricians to participate in interventions on this topic. The results could facilitate the development and realization of a well-accepted and therefore cost-efficient training program on childhood stroke.

Methods: The survey was developed by experts in pediatric neurology, pediatric hemostaseology, and pediatric emergency medicine of our research group. A total of 1,697 physicians of pediatric in- and outpatient facilities in Bavaria, Germany, were invited via e-mail to an online survey about childhood stroke. The completion of the entire survey took about 5 minutes. Of the addressed 1,697 pediatricians, 1,258 are members of the Bavarian section of a resident doctors’ association of pediatricians in Germany. Furthermore, all pediatricians working at three children’s hospitals or their social pediatric centers (SPZ) located in Munich, Germany (n = 391) and a neuropediatric rehabilitation center (n = 48) in the vicinity of Munich were asked to participate.

Results: The overall participation rate was 14%. Forty-six per cent of participants considered a diagnosis of childhood stroke at least once during the past year, and 47% follow-up patients after stroke. The Face–Arm–Speech–Time test was correctly cited in 27% questionnaires. Most commonly quoted symptoms of childhood stroke were hemiparesis (90%), speech disorder (58%), seizure (44%), headache (40%), and impaired consciousness (33%). Migraine (63%), seizure (39%), and infections of the brain (31%) were most frequently named as stroke mimics. Main therapeutic strategies were thrombolysis (80%), anticoagulation (41%), neuroprotective measures, and mechanical thrombectomy (15% each). Thirty-nine per cent of participants had taken part in training sessions, 61% studied literature, 37% discussed with colleagues, and 25% performed internet research on childhood stroke. Ninety-three per cent of participants approve skill enhancement, favoring training sessions (80%), publications (43%), and web-based offers (35%). Consent for offering a flyer on the topic to caregivers in facilities was given in 49%.

Conclusion: Childhood stroke constitutes a topic of clinical importance to pediatricians. Participants demonstrate a considerable level of comprehension concerning the subject, but room for improvement remains. A multimodal approach encompassing an elaborate training program, regular educational publications in professional journals, and web-based offers could reach a broad range of health care providers. Paired with a public adult and childhood stroke awareness campaign, these efforts could contribute to optimize the care for children suffering from stroke.