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Letter
Childhood stroke guidelines, a grey matter
  1. Ed Abrahamson,
  2. James Ross
  1. Paediatric Emergency Department, Chelsea and Westminster Hospital, London SW10 9NH, UK
  1. Correspondence to Dr James Ross, Paediatric Emergency Department, Chelsea and Westminster Hospital, London SW10 9NH, UK; james.ross{at}chelwest.nhs.uk

http://dx.doi.org/10.1136/archdischild-2018-314986

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    Management algorithms are a cornerstone of clinical guidelines, if applicable, directing the clinician through a variety of steps and options, dependent on the individual case. The end point of each arm of an algorithm is generally a definitive recommendation.

    The otherwise comprehensive and excellent Stroke in Childhood guidelines (Stroke Association/Royal College of Paediatrics and Child Health, May 2017)1 fail in this regard, in relation to arterial ischaemic stroke.

    While the narrative in section 6.2.1 describes criteria for treatment consideration in general, the algorithm states ‘thrombolysis may be considered if 2–8 years old, and could be considered if >8 years.’ The words ‘may’ and …

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    Footnotes

    • EA and JR contributed equally.

    • Contributors The letter was jointly written by both authors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.