Scott Webb (Host): Welcome to UK HealthCast, the podcast from UK HealthCare. I'm Scott Webb. And although strokes in pediatric patients are rare, the effects can be just as devastating as they are for adults. And joining me today to discuss the prevalence and treatment for pediatric stroke and how UK HealthCare and Kentucky Neuroscience Institute are uniquely positioned to care for those patients is Dr. Kevin O'Connor. He's a vascular neurologist who specializes in pediatric stroke.

Dr. O'Connor, thanks so much for your time today. We're going to talk about the prevalence and treatment for pediatric stroke. And as I mentioned to you before we got rolling here, I've done lots of stroke podcasts, but not pediatric stroke podcasts. So, this is going to be educational for me, for listeners. How common is pediatric stroke and who's at the highest risk?

Dr. Kevin O'Connor: Yeah. Well, thanks for having me. And I'm glad you brought up the fact that you've not done very many pediatric stroke podcasts, because that ties in very nicely to how common it is, which is to say that it's much less common than the adult stroke version. And when we think about overall numbers, it's somewhere around the range of one to three children out of every 100,000 in a given year. And when you think about a small population like Kentucky, it may not be that many. But when it happens to your child, then it's obviously going to be a big deal.

Host: Yeah. I think that's probably the biggest takeaway, right? As you say, it's not very common. You know, between one and three and a hundred thousand. But If it was my child, it would be really important to me. And so, maybe that's the audience that we're speaking to today. So, let's talk about that. Why is the awareness of pediatric stroke so important?

Dr. Kevin O'Connor: Like all strokes, awareness is important because if we can let people know this is what a stroke looks like, then we can get you to come in and see us. And oftentimes, there are things that we can do in that very short window where the symptoms start that we can't do much later on. And a lot of the things we tell our adult population, you know, you got to get to the hospital, sometimes we have this clot-busting medicine, sometimes we're able to go in and pull a clot out, those same things apply to a child. And when we think about the potential for disability from a stroke, when you're a much older person, we might not think, oh, you know, 10 years, 20 years of disability. But when it's a child, that might be several decades of disability.

And that's where the awareness around pediatric stroke becomes really important, is because you don't want an eight-year-old child to have to spend the rest of their life with a significant weakness on one side, language trouble, things like that. So, being aware of the signs of a stroke can get you to come and see us a little bit sooner, and then maybe we can do something to help reverse some of that potential damage.

Host: Yeah, I've heard this before, and I've heard myself say this before in an adult stroke podcast, that time is brain. What does that mean, doctor?

Dr. Kevin O'Connor: Yeah. So, we like to say time is brain, because for every second, every minute that your brain goes without good blood flow with good oxygen, then those brain cells, they're not going to do very well. And if that goes on for too long, then those brain cells are going to die. And if those are the brain cells that help move your left leg, that help with your vision on your right side, that help you think through math problems, you're going to kind of want to save as many of those as you'd like, unless you really don't like doing math. But overall, we want you to take care of as much of your brain as possible, and the sooner we can try to reverse the potential damage from a stroke, the more brain we can save.

Host: Yeah. So time is brain, of course. So, for the children who are at risk, let's talk about who's at risk. And then if you're a parent of a child at risk, what do we do if we're concerned about them having a stroke?

Dr. Kevin O'Connor: So, when we're concerned about children having a stroke, we tend to think along the lines of a mnemonic we like to use being BEFAST, B-E-F-A-S-T. And we emphasize that because it highlights the potential for balance problems or walking difficulty; eye problems where maybe your eyes aren't looking in the right direction or you're having vision problems, maybe you're not seeing on the left or you've lost vision in one eye; your face is a little bit droopy; you might have problems moving your arms or your legs or feeling your arms or your legs on one side. And then, the S would be speech, language, so if you can't talk, can't understand. And then, the T emphasizes time. So, what we want parents and other caregivers to be aware of is that if you have a child that has any one of those things happen suddenly, then we would like for you to contact EMS, get to the hospital as quickly as possible, because that could be a pediatric stroke. It won't always be, but it could be.

Host: Yeah. And as we're saying here, time is brain, and always better to be safe than sorry, especially when it comes to stroke and our little ones. I just want to wrap up here today, doctor, and talk about what UK is doing specifically to improve pediatric stroke care.

Dr. Kevin O'Connor: So, we've done quite a few things as an institution. We have a specific process where if a child shows up to our hospital with any one of those BEFAST symptoms and they've shown up within, you know, the last 24 hours, we run them through triage process to evaluate for the presence of a stroke. And part of that triage process is determining whether or not they're a candidate for some of the acute therapies we have for stroke, for example, the clot-busting medicine we like to refer to, or doing a thrombectomy where we pull out the clot.

As part of a larger effort, UK has partnered with the University of Louisville and Norton Children's to develop a similar triage process that can be used statewide, because we know that children won't always show up to the closest children's hospital, they'll just show up to the closest hospital. And we want our other hospitals in the region to be as prepared for potentially managing a pediatric stroke as we are, so we've developed this algorithm and process where if a child shows up anywhere but the University of Kentucky, they can still work through the problem and they can give us a call and we can help them sort that out.

Host: That's perfect. I know you and I are scheduled to speak again. And we're going to talk specifically about the algorithm and what's involved. So, I look forward to that. And thank you so much.

Dr. Kevin O'Connor: Thank you.

Host: And for more information, visit our website at ukhealthcare.com. And that wraps up another episode of UK HealthCast from UK HealthCare. Please remember to subscribe, rate and review this podcast and all the other UK HealthCare podcasts. I'm Scott Webb. Stay well.