Australia's first clinical guidelines for children with stroke

Children will receive faster diagnosis and life-changing treatment with the first clinical guidelines in Australia to help them recover from stroke.

Doctors from Murdoch Children's Research Institute and The Royal Children's Hospital developed the childhood guidelines to improve paediatric care. Before the guidelines were introduced, children could often wait more than a day for a stroke diagnosis, missing the critical window to reduce brain injury and improve recovery.

Murdoch Children's researcher and paediatric neurologist Associate Professor Mark Mackay, who led the development of the guidelines, says they aim to create better standards of care for childhood stroke across Australian paediatric hospitals.

"This will help reduce the time to diagnose stroke and ensure all children are provided with the same high-quality evidence-based care,"

A/Prof Mackay says, "Stroke is among the top 10 causes of death in children; more common than brain tumours. In Australia between 100 and 300 Australian babies and children are diagnosed with a stroke each year. More than half of those who survive will have lifelong disabilities affecting their physical functioning, communication, learning and social behaviour.

"The lifelong burden of stroke is greater for children than adults, because more than half of strokes occur in children under-five. These children, therefore, face decades of living with disability," A/Prof Mackay says.

"Children face difficulties ever achieving an independent life because the stroke happens while the child's brain is still developing."

According to MCRI's Dr Tanya Medley, who also worked on the guidelines, the causes of stroke in children are very different to adults, requiring changes to typical treatment.

"We believe implementing a standardised approach to diagnosis and management will ensure children are not being left behind in the advances in stroke care that have transformed outcomes for adults," Dr Medley says.

The new paediatric clinical guidelines, which began implementation in 2018 and have received endorsement from the Stroke Foundation and the Australian and New Zealand Child Neurology Society, will address the need for fast, evidence-based action.

A key recommendation of the guidelines is that rehabilitation is delivered by a team of health professionals such as occupational therapists, physiotherapists, speech pathologists and dieticians.

"The guidelines have helped us identify key research questions and develop a national collaborative network," says A/Prof Mackay, who is also Director of The Royal Children's Hospital Stroke Program.

"We hope that setting a national research agenda will help us attract much-needed funding to improve our knowledge of the best approaches to treating Australian children who have had a stroke."

Read the guidelines: doi/10.1177/1747493018799958