ISC 2026 | AHA/ASA 2026 guideline on acute ischemic stroke: updates regarding pediatric stroke

So these guidelines took a first attempt at trying to provide some guidance to pediatric stroke care. And that’s very necessary. We know that pediatric children can have strokes. And when they do, they present differently. They don’t present like adults. They can have different symptoms, more generalized symptoms instead of focused symptoms. Sometimes a seizure can be the first presentation of stroke in children. So getting the system, the stroke system of care, the community of healthcare providers to be aware of that is one message in the guidelines. And trying to make efforts to educate your peers about that is really important. Having protocols is really important. We also took the approach that certain things could be introduced as guidelines for pediatric care with a lower grade of evidence because trials have been either unable to be completed or not completed, not done at all yet in pediatrics. And this is a call to get more studies, more international multicenter studies for pediatric stroke patients. But even in the absence of that, we did take little baby steps. One was to say that alteplase could be given in some cases with pediatric stroke presentations within the first four and a half hours up to about, you know, from 28 days to 18 years of pediatric patients, as well as the use of thrombectomy devices in patients who have a large vessel occlusion coming in to the hospital up to even up to 24 hours. So we’re pushing the envelope a little bit to try to give options for our pediatric healthcare providers and, of course, the patients.

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