Journal article
Breaking barriers in pediatric stroke care: a comprehensive systematic review and meta-analysis of emergency department management practices
Italian journal of pediatrics, v 51(1), 293
27 Oct 2025
PMID: 41146173
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Pediatric stroke is a life-threatening emergency condition characterized by a wide range of presentations, which frequently delays the diagnosis and intervention. This study aimed to evaluate the clinical presentation, diagnostic approaches, and outcomes of pediatric patients presenting with suspected stroke in emergency settings. A systematic search was conducted in PubMed, Embase, Cochrane Library, Scopus, and Web of Science for studies published up to May 2024. Nineteen peer-reviewed studies investigating pediatric stroke in emergency settings were included. A qualitative synthesis was performed, and meta-analysis was conducted when appropriate. The risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cohort and Case Series Studies. Out of 2,958 identified records, 19 studies (13 cohort studies and 6 case series) met the inclusion criteria, with 8 eligible for meta-analysis. The pooled mortality rate was 19.2% (95% CI: 8.1%-30.4%), while intubation and ICU admission were required in 21.6% (95% CI: 10.9%-32.3%) and 37.6% (95% CI: 18%-57.2%) of cases, respectively. The average hospital stay was 11.12 days (95% CI: 8.58-13.65). CT was more frequently used (80.71%) than MRI (35.86%) for neuroimaging. The mean time from symptom onset to diagnosis was 9.95 h. Variability in prehospital management and diagnostic accuracy was noted across studies. Migraines (19.39%) and seizures (12.75%) were the most common non-stroke diagnoses reported. Pediatric stroke remains underrecognized and frequently misdiagnosed in emergency settings. Delays in diagnosis, reliance on CT over MRI, and inconsistent triage practices contribute to suboptimal outcomes. Standardized, pediatric-specific stroke protocols emphasizing early recognition, appropriate imaging, and timely intervention are urgently needed to improve patient care and outcomes.
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Details
- Title
- Breaking barriers in pediatric stroke care: a comprehensive systematic review and meta-analysis of emergency department management practices
- Creators
- Mohamed Basyouni Helal - Menoufia UniversityIbrahim Kamal - Al-Azhar UniversityMohammed Alsabri (Corresponding Author) - St. Christopher's Hospital for ChildrenMohamed Sayed Zaazouee - Al-Azhar UniversityMostafa A Khalifa - Cairo UniversityShaima Omer Mohamed Elawad - University of KhartoumMayar M Aziz - Menoufia UniversityRehab Emad Ashmawy - Helwan UniversityDina Essam Abo-Elnour - Zagazig UniversityNicholas Aderinto - Ladoke Akintola University of TechnologyJean Marie A Rinnan - St. Christopher's Hospital for Children
- Publication Details
- Italian journal of pediatrics, v 51(1), 293
- Publisher
- BioMed Central
- Number of pages
- 20
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; College of Medicine
- Web of Science ID
- WOS:001600815100001
- Scopus ID
- 2-s2.0-105019795183
- Other Identifier
- 991022124258404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics