Research Shedding New Light On Causes and Treatments of Pediatric Stroke

Neuroscience Research | November 17, 2018 | cookchildrens

In 2009, Fernando Acosta, M.D. and Marcela Torres, M.D. created an outpatient multidisciplinary comprehensive stroke clinic with the primary goal of improving stroke care and patient outcomes. With this goal at the forefront, they joined the International Pediatric Stroke Study and opened for enrollment in April 2012. The study entitled “Towards the Establishment of Standards of Practice and the Initiation of Multi-Center, Multi-National Clinical Trials for Neonates and Children with Stroke (IPSS)” continues to enroll pediatric stroke patients internationally and Cook Children's remains one of the most active partners. The data collected has led to numerous publications related to the diagnosis, prevention and management of stroke in children.

In 2013, the Thrombolysis in Pediatric Stroke (TIPS) study, with funding from the National Institute of Neurological Disorders and Stroke (NINDS), set out to systematically gain competence in the response to and assessment of children presenting with acute ischemic stroke for treatment with tissue plasminogen activator (tPA). This study prompted the development of pediatric stroke centers comprised of a multidisciplinary team and hospital support to execute acute interventions in the pediatric setting. Although the study closed due to low enrollment in April 2014, Cook Children's was approved for enrollment as a pediatric stroke center, one of only 16 such centers. This resulted in the expansion from the outpatient clinic to a full inpatient multidisciplinary stroke service. Cook Children's continues to develop partnerships with adult facilities regionally to provide quality care to pediatric stroke patients both acutely and long term.

The collaboration between Cook Children's and IPSS continues to foster opportunities to participate in other multi-national research endeavors. This month, Cook Children's opened enrollment in the Vascular Effects of Infection in Pediatric Stroke (VIPS) study. Data collected by IPSS sites discovered that clinical infection acts as a trigger for stroke in children. Aims of this study are to identify known and novel pathogens in children with acute ischemic stroke (AIS) to determine whether different pathogens are associated with arteriopathic versus cardioembolic or idiopathic stroke. In addition, the study will look to determine whether children with arteriopathic AIS have an alternative pathway of inflammation compared to children with cardioembolic or idiopathic stroke and finally to determine which genes and pathways are dysregulated after AIS, and how they correlate with stroke etiology.

The Cook Children's Stroke and Thrombosis Program was developed to improve stroke care and patient outcomes and continues to pursue these goals through active participation in research, clinical care, and efforts to increase awareness of pediatric stroke.

Contributing staff

Tilley, RN, CPNP, Cook Children's Stroke and Thrombosis ProgramJo Ann Tilley, DNP, RN, CPNP
Cook Children's Stroke and Thrombosis Program

Cook Children's Neurosciences team

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