Pediatric strokes are rare and challenging to diagnose. There is a validated Pediatric Stroke Scale from the NIH that can be used in conjunction with a stroke protocol that involves Neurology, Radiology, and a local/regional Stroke Team. 

Review the tool at MD Calc, the direct link is – https://www.mdcalc.com/calc/10270/pediatric-nih-stroke-scale-nihss – 

MD Calc Pediatric NIH Stroke Scale

 

Important notes

  • The overall true predictive value of the Pediatric NIH stroke scale continues to be studied. Retrospective use has been shown to be valid and reliable in one cross-sectional study (Beslow 2012).This score has not been validated in hemorrhagic stroke; and thus availability of Neurosurgery is paramount
  • Pediatric strokes are rare, and tPA is still being investigated; the true benefit of tPA is not well defined
  • Children with sickle cell disease presenting with acute ischemic stroke will likely benefit from emergent blood transfusion to reduce hyperviscosity. Early consultation with a pediatric hematologist and neurologist is mandatory.

References / Key Articles

Ichord RN, Bastian R, Abraham L, et al. Interrater reliability of the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) in a multicenter study. Stroke. 2011;42(3):613-7. The original primary reference

Beslow LA, Kasner SE, Smith SE, et al. Concurrent validity and reliability of retrospective scoring of the Pediatric National Institutes of Health Stroke Scale. Stroke. 2012;43(2):341-5. Validation study