The second national paediatric stroke conclave, held in Bengaluru, shed light on a critical issue: the alarming lack of awareness regarding paediatric stroke in India. Experts, including Dr Nirmal Surya, president of the Indian Stroke Association (ISA), emphasized the urgent need to raise awareness about this condition, which often leads to delayed diagnosis and treatment.
Dr Surya highlighted that stroke is preventable, yet it remains the sixth leading cause of death among children globally. He attributed this to the lack of awareness, which is particularly pronounced in India. “When people are not aware of the possibility of stroke in children, valuable time is lost on misdiagnosis,” he explained. “Time is of the essence because stroke can often be treated with injection if the patient is brought within four and a half hours.”
Dr Minal V Kekatpure, a paediatric neurologist at Narayana Health, Bengaluru, and the conclave’s organizing secretary, emphasized that stroke can occur even on the day of birth. She revealed that paediatric stroke is more common among newborns than older children, with approximately 25 cases per 100,000 neonates compared to 12 cases involving older children.
Dr Pratibha Singhi, president of the International Child Neurology Association, shared anecdotal evidence of parents misinterpreting stroke symptoms. “We have had instances where parents brought their child seeking remedy for ‘not very good at writing’, and on checking we found that the child actually had suffered a stroke and is unable to move the hand properly,” she shared.
The lack of awareness extends beyond parents, as Dr K P Vinayan, Paediatric Neurology Sub Section Chair of the Indian Academy of Neurology, pointed out that even adults experiencing stroke often miss the critical window for treatment, increasing the chances of disability or even death.
International experts, such as Dr Maja Steinlin, vice-president of the International Paediatric Stroke Organisation, echoed the concerns, noting that awareness is a challenge even in Western countries. She emphasized that India’s issue is not a lack of qualified personnel but rather the lack of timely access to treatment.
The conclave aimed to address this by fostering awareness, connecting paediatricians and general practitioners with stroke-ready hospitals, and promoting the use of technology to improve response times. Dr Arvind Sharma, secretary of ISA, highlighted the need for a robust network of accredited stroke centers, pointing out that India currently has only 13 primary centers and 30 stroke-ready but not accredited facilities. He emphasized the need for at least 1,000 accredited hospitals to adequately manage stroke cases in the country.
Dr Vikram Huded, organizing chairman of the conclave and interventional neurologist at Narayana Health, Bengaluru, stressed that even in adult stroke cases, only 1-2% of patients receive timely treatment. The statistics for paediatric stroke are even more concerning. While advancements in understanding paediatric stroke have been made, the lack of awareness continues to hinder effective treatment and outcomes.
Experts from around the world shared their experiences and knowledge to encourage collaboration and increase awareness. The use of apps in the United States and Canada, connecting paediatric neurologists across the country to provide immediate assistance, was presented as a potential model for India.
While acknowledging the limited number of paediatric neurologists in India, Dr Surya emphasized that the more pressing issue is the lack of patients accessing available facilities. He stated that India should be performing 250,000 thrombosis procedures annually, but the current number is only between 2,000 and 3,000, highlighting a significant gap.
In conclusion, the experts unanimously agreed that raising awareness is the most crucial step towards improving outcomes for paediatric stroke patients in India. The conclave served as a platform to educate, connect, and inspire action to address this critical health issue.
