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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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