Abstract
Objective: Acute childhood stroke is an emergency requiring a high level of awareness among first-line healthcare providers. This survey serves as an indicator of the awareness of, the interest in, and knowledge of childhood stroke of German pediatricians.Methods: Thousand six hundred and ninety-seven physicians of pediatric in- and outpatient facilities in Bavaria, Germany, were invited via email to an online-survey about childhood stroke.Results: The overall participation rate was 14%. Forty-six percent of participants considered a diagnosis of childhood stroke at least once during the past year, and 47% provide care for patients who have suffered childhood stroke. The acronym FAST (Face-Arm-Speech-Time-Test) was correctly cited in 27% of the 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 diagnostic measures indicated were magnetic resonance imaging (MRI) (96%) and computer tomography (CT) (55%). Main therapeutic strategies were thrombolysis (80%), anticoagulation (41%), neuroprotective measures, and thrombectomies (15% each). Thirty-nine percent 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 percent 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 multi-modal 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.
Highlights
Given the reported annual incidence of pediatric arterial ischemic and hemorrhagic stroke of 1.2–13/100,000, strokes belong to the rare conditions in the pediatric population [1]
The return rate for pediatricians practicing in institutions in the region of Munich was substantially higher (28%), which to the one hand may reflect the higher likelihood to be exposed to children with suspected childhood stroke in the hospital than in the doctor’s office
Childhood stroke constitutes a topic of clinical importance to pediatricians in daily professional routine in all settings
Summary
Given the reported annual incidence of pediatric arterial ischemic and hemorrhagic stroke of 1.2–13/100,000, strokes belong to the rare conditions in the pediatric population [1]. The aim of this study was to get reliable information on [1] the rate of awareness of childhood stroke, [2] the level of knowledge that future education efforts may build on, and [3] the acceptance of different educational measures in a representative cohort of pediatricians. These results will facilitate the successful development and realization of a well-accepted and cost-efficient training program on the topic of childhood stroke
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