On May 3, 2016, Dr. Mónica García, Member of Parliament for Podemos, presented in the Madrid Assembly the NLP that we had drafted on the children’s stroke code.
Dr. Pedro de Castro, neuropediatrician at the Gregório Marañón Hospital, presented information on the scientific evidence of children’s stroke to the Health Commission. Following a compromise amendment, all parties voted in favour.
Podemos MPs after the registration of the NLP of the children’s stroke code. Maribela Gutiérrez and Paloma Pastor in the Madrid Regional Parliament.
On 20 June 2016, the first meeting of the Observatory of Brain Injury was convened, where the Children’s Stroke Code working group, after two years of work, has drafted a document that determines how the implementation of the paediatric stroke code should be in the Community of Madrid.
Cerebral Injury Observatory Meeting
Finally, in February 2019, the Department of Health has begun the implementation of the Pediatric Stroke Code in three hospitals in the region. With the implementation of this procedure, the Community of Madrid will be a pioneer at a national level.
Stroke in paediatric age is an important diagnostic and therapeutic challenge. Although it is unusual in comparison with adulthood, its frequency is similar to that of primary brain tumours in paediatric age, with the fundamental difference that paediatric stroke is an emergency.
In children suffering ischemic stroke, diagnosis is often delayed by difficulties in recognizing the acute neurological deficit and the rare consideration of its infrequency. This delay means that the possibility of referral to a centre with specialised paediatric equipment is missed. Consequently, neurological examination and diagnostic imaging tests are delayed and reperfusion treatment possibilities are not considered in the case of ischemic strokes. To this end, early diagnosis is the main tool to apply therapeutic measures that can limit brain injury and its consequences.
The objective of this procedure is for the patient to arrive at the hospital, which has specialists and technical means to attend patients with neurointerventionism, within two hours of the onset of symptoms and within one hour of the activation of the code. The incidence of ischemic stroke in the age group 29 days to 16 years is 16/100,000 children per year.
The hospitals with neurointerventionism that will attend the pediatric stroke code are the Gregorio Marañón Hospital, the 12 de Octubre Hospital and the La Paz Hospital. These hospitals will be shifting guards and there will always be one available to assist children under 16 years with this pathology, 24 hours a day 365 days a year.
The protocol will be activated following the inclusion criteria reflected in the Pediatric Stroke Care Document that has been disseminated to all hospitals in the Community of Madrid, either from Summa or through the request of other hospitals for referral to one of the three previously reflected with greater diagnostic and therapeutic complexity.