title: Preparing for a "Pediatric Stroke Alert".
abstract: BACKGROUND
  Childhood arterial ischemic stroke is an important cause of morbidity and mortality in children. Hyperacute treatment strategies remain controversial and challenging, especially in the setting of increasingly proven medical and endovascular options in adults. Although national and international pediatric guidelines have given initial direction about acute therapy and management, pediatric centers have traditionally lacked the infrastructure to triage, diagnose, and treat childhood arterial ischemic stroke quickly.
  
  
  METHODS
  In the past 10 years, researchers in the International Pediatric Stroke Study and Thrombolysis in Pediatric Stroke study have initiated early strategies for establishing pediatric specific stroke alerts.
  
  
  RESULTS
  We review the rationale, process and components necessary for establishing a pediatric stroke alert.
  
  
  CONCLUSIONS
  Development of pediatric stroke protocols and pathways, with evidence-based acute management strategies and supportive care where possible, facilitates the evaluation, management, and treatment of an acute pediatric stroke.
authors.affiliation: Hemophilia and Thrombosis Center, University of Colorado School of Medicine, Aurora, Colorado; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Electronic address: Timothy.Bernard@childrenscolorado.org.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bernard
authors.affiliation: Center for Pediatric Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Neil R
authors.initials: NR
authors.lastname: Friedman
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Nicholas V
authors.initials: NV
authors.lastname: Stence
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: William
authors.initials: W
authors.lastname: Jones
authors.affiliation: Department of Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ichord
authors.affiliation: Seattle Children's Hospital, Department of Neurology, University of Washington, Seattle, Washington.
authors.forename: Catherine
authors.initials: C
authors.lastname: Amlie-Lefond
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics and Neurology, University of Texas Southwestern Medical Center Dallas, Dallas, Texas.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Dowling
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts; Department of Radiology, Boston Children's Hospital, Boston, Massachusetts; Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rivkin
mesh_terms: D002545:Brain Ischemia / Q000150:complications; D019468:Disease Management; D006801:Humans; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*
keywords: TIPS trial; arterial ischemic stroke; childhood stroke; pediatric stroke centers