Can the FAST and ROSIER adult stroke recognition tools be applied to confirmed childhood arterial ischemic stroke?

BMC Pediatrics

Mark T Mackay²  Ian T Mosley³  Franz E Babl⁴  Adriana Yock-Corrales¹ 

[1] Murdoch Children's Research Institute, Melbourne, Australia;Department of Neurology, Royal Children's Hospital, Melbourne, Australia;Monash University, Melbourne, Australia;University of Melbourne, Melbourne, Australia

关键词: emergency department;    child;    ROSIER;    FAST;    stroke recognition tools;    Stroke;   

Others  :  1172116
DOI  :  10.1186/1471-2431-11-93

 received in 2011-04-28, accepted in 2011-10-21,  发布年份 2011

【 摘 要 】

Background

Stroke recognition tools have been shown to improve diagnostic accuracy in adults. Development of a similar tool in children is needed to reduce lag time to diagnosis. A critical first step is to determine whether adult stoke scales can be applied in childhood stroke.

Our objective was to assess the applicability of adult stroke scales in childhood arterial ischemic stroke (AIS)

Methods

Children aged 1 month to < 18 years with radiologically confirmed acute AIS who presented to a tertiary emergency department (ED) (2003 to 2008) were identified retrospectively. Signs, symptoms, risk factors and initial management were extracted. Two adult stroke recognition tools; ROSIER (Recognition of Stroke in the Emergency Room) and FAST (Face Arm Speech Test) scales were applied retrospectively to all patients to determine test sensitivity.

Results

47 children with AIS were identified. 34 had anterior, 12 had posterior and 1 child had anterior and posterior circulation infarcts. Median age was 9 years and 51% were male. Median time from symptom onset to ED presentation was 21 hours but one third of children presented within 6 hours. The most common presenting stroke symptoms were arm (63%), face (62%), leg weakness (57%), speech disturbance (46%) and headache (46%). The most common signs were arm (61%), face (70%) or leg weakness (57%) and dysarthria (34%). 36 (78%) of children had at least one positive variable on FAST and 38 (81%) had a positive score of ≥1 on the ROSIER scale. Positive scores were less likely in children with posterior circulation stroke.

Conclusion

The presenting features of pediatric stroke appear similar to adult strokes. Two adult stroke recognition tools have fair to good sensitivity in radiologically confirmed childhood AIS but require further development and modification. Specificity of the tools also needs to be determined in a prospective cohort of children with stroke and non-stroke brain attacks.

【 授权许可】

   
2011 Yock-Corrales et al; licensee BioMed Central Ltd.

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