- Pediatric ischemic stroke trials: As of November 2024, likely due to the relative rarity of pediatric ischemic stroke, there are no prospective and large-scale trials with exclusively pediatric subjects to inform the management of ischemic stroke in children (278,279). Essentially all of the existing recommendations are derived from adult trials or case series from the pediatric literature, which often suffer from the presence of extraneous variables. Pediatric and adult ischemic stroke are not the same entity. Moreover, the physiology of children, particularly those of younger age, varies from that of adults. It is therefore highly unlikely that best practices in adult stroke care will always translate to pediatrics. As these trials may require several years for completion, centers may find it reasonable to create a standard pediatric stroke pathway in the meantime. The role for endovascular intervention in pediatric ischemic stroke remains poorly defined and merits attention in this new era of thrombectomy. Determining which interventions, both medical and surgical, work best for certain stroke etiologies, age groups, and other patient characteristics may help personalize the management of ischemic stroke for individual children.
- Endovascular devices: New stent retrievers, aspiration catheters, and embolic protection devices have been recently introduced or are in production (66,238). Their role in the management of pediatric ischemic stroke is largely unclear.
- Improved understanding of elusive etiologies: Ischemic stroke in children may be caused by infectious and noninfectious inflammatory processes, but these remain poorly understood. Ongoing work in the field of molecular biology seeks to elucidate their pathogenesis and genetic risk factors to improve stroke care and genetic counseling (280).
Please create a free account or log in to read 'On The Horizon for Ischemic Cerebrovascular Disease in Children'
Registration is free, quick and easy. Register and complete your profile and get access to the following:
- Full unrestricted access to The ISPN Guide
- Download pages as PDFs for offline viewing
- Create and manage page bookmarks
- Access to new and improved on-page references
