Abstract TP498: Application of F.A.S.T Algorithm to Pediatric Stroke: A Comprehensive Stroke Center Retrospective Analysis

Abstract

Objective: To assess the demographic characteristics and presenting symptoms of a cohort of children who were admitted with ischemic stroke and develop a modification of an adult stroke recognition tool that would applicable to pediatric population. Method: We conducted a retrospective medical record review of all children aged 1 month to 18 years with radiologically confirmed ischemic stroke who were admitted to the University of Kentucky between January 2013-December 2017. Age, sex, race, presenting symptoms, stroke etiology and discharge disposition were recorded. The FAST mnemonic (Face, Arm, Speech) was applied to all patients. Results: There were 38 children with ischemic stroke (89% Caucasian, 73% boys). The strokes were most commonly associated with traumatic (28%) followed by intracranial infection (21%). FAST accurately identified 21 of stroke patients (61%), but only 35.7% of the children < 3 years of age. The addition of new onset seizures to FAST (FAST-S) increased overall sensitivity to 78.9% and to 100% in the 1month - 3 years’ age group. Conclusions: Unlike adults, the most common causes of pediatric stroke in our cohort were trauma and infection. FAST is not sensitive in the pediatric population, particularly in children <3-years old. The addition of new onset seizures in children to FAST improves stroke identification.