title: [Experts' recommendations: stroke management in the intensive care unit. Pediatric specificities (excluding neonates)].
abstract: Stroke in children is not rare. Although there are no randomized trials on childhood stroke, except in sickle cell disease patients, several international guidelines have described quality criteria for stroke management in children. Age-adapted management is required, involving collaboration with a pediatric neurologist and hospitalization in a pediatric intensive care or continuous care unit. All symptomatic treatments used in adults can be recommended in children, including homeostasis assessment and maintenance or blood exchange in sickle cell disease patients. Specific treatments such as thrombolysis or mechanical thrombectomy are not recommended in children, except in the framework of clinical trials, but can be beneficial in adolescents. Multidisciplinary decision-making should be the rule in such situations. Adolescents may be managed in adult stroke units. Indications for surgery in children are adapted from adult guidelines. Appropriate management of cerebral venous thrombosis in children is similar to that in adults. The best management possible can be achieved through a multidisciplinary dialogue between the pediatric neurologist and the adult intensivist or neurologist.
authors.affiliation: Service de neurologie pédiatrique, hôpital Necker-Enfants-Malades, 149 rue de Sèvres, Paris cedex 15, France. manoelle.kossorotoff@nck.aphp.fr
authors.forename: M
authors.initials: M
authors.lastname: Kossorotoff
authors.forename: P
authors.initials: P
authors.lastname: Meyer
authors.forename: A
authors.initials: A
authors.lastname: Lebas
authors.forename: S
authors.initials: S
authors.lastname: Chabrier
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods / Q000592:standards*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D019586:Intracranial Hypertension / Q000209:etiology / Q000628:therapy; D010372:Pediatrics / Q000592:standards; D020521:Stroke / Q000150:complications / Q000628:therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator