Pediatric Intracerebral Hemorrhage Management—Consensus Statement of the International Pediatric Stroke Organization—Part 1: Acute Phase and Workup

Pediatric intracerebral hemorrhage (pICH) is a rare but serious neurologic emergency associated with significant morbidity. Although pICH accounts for nearly half of all pediatric strokes, it remains understudied, and dedicated evidence-based management guidelines are lacking. To address this gap, the International Pediatric Stroke Organization convened a multidisciplinary international working group in 2020 to develop a comprehensive, consensus-based framework for the acute evaluation and management of pICH in children aged 28 days to 18 years. The working group included child neurologists, neurointensivists, neurosurgeons, neuroradiologists, and neurointerventionalists. Subgroups conducted systematic literature reviews and formulated key clinical questions. A modified Delphi process was used to derive consensus statements across 6 domains: prehospital and emergency care, diagnostic imaging and workup, neurocritical care and medical management, neurosurgical and neurointerventional approaches, and identification of knowledge gaps. Through rounds of structured review and voting, 21 consensus statements were developed and approved. The process was endorsed by multiple professional societies. This represents the first international, multidisciplinary, multisociety consensus statement focused on the acute management of pICH in children. It provides structured, expert-driven guidance to inform clinical decision-making, reduce practice variability, and highlight areas for future research. These consensus statements aim to support clinicians worldwide in improving outcomes for children with pICH.

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Publication Details

Journal
Journal of the American Heart Association
Published
2025-12-30
DOI
https://doi.org/10.1161/jaha.124.039594
Citations
1
Primary Topic
Intracerebral and Subarachnoid Hemorrhage Research
Type
article
Field-Weighted Citation Impact
1.39
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article

Pediatric Intracerebral Hemorrhage Management—Consensus Statement of the International Pediatric Stroke Organization—Part 1: Acute Phase and Workup

Arastoo Vossough, Mahesh Chikkannaiah, Jonathan Andrew Grossberg, Nomazulu Dlamini et al.
1 citations
Journal of the American Heart Association
Intracerebral and Subarachnoid Hemorrhage Research
1.39
article

Pediatric Intracerebral Hemorrhage Management—Consensus Statement of the International Pediatric Stroke Organization—Part 1: Acute Phase and Workup

Arastoo Vossough, Mahesh Chikkannaiah, Jonathan Andrew Grossberg, Nomazulu Dlamini, Martin G. Radvany, Sudhakar Vadivelu, Joan Martí‐Fàbregas, Lauren A. Beslow, Neeraj Chaudhary, Dana Harrar, Flavio Requejo, Christine Mrakotsky, Heather J. Fullerton, Michaela Waak, Laura L. Lehman, Peter Bernhard Sporns, Grégoire Boulouis, Mathilde Chevignard, Christine K. Fox, Moran Hausman‐Kedem, Janette Mailo, Akash P. Kansagra, Lauren Beslow, Bo Jiang, Beverly Aagaard‐Kienitz, Marco Pasi, Max Wintermark, Olivier Naggara, Sandro Benichi
article en
1 citations

Abstract

Pediatric intracerebral hemorrhage (pICH) is a rare but serious neurologic emergency associated with significant morbidity. Although pICH accounts for nearly half of all pediatric strokes, it remains understudied, and dedicated evidence-based management guidelines are lacking. To address this gap, the International Pediatric Stroke Organization convened a multidisciplinary international working group in 2020 to develop a comprehensive, consensus-based framework for the acute evaluation and management of pICH in children aged 28 days to 18 years. The working group included child neurologists, neurointensivists, neurosurgeons, neuroradiologists, and neurointerventionalists. Subgroups conducted systematic literature reviews and formulated key clinical questions. A modified Delphi process was used to derive consensus statements across 6 domains: prehospital and emergency care, diagnostic imaging and workup, neurocritical care and medical management, neurosurgical and neurointerventional approaches, and identification of knowledge gaps. Through rounds of structured review and voting, 21 consensus statements were developed and approved. The process was endorsed by multiple professional societies. This represents the first international, multidisciplinary, multisociety consensus statement focused on the acute management of pICH in children. It provides structured, expert-driven guidance to inform clinical decision-making, reduce practice variability, and highlight areas for future research. These consensus statements aim to support clinicians worldwide in improving outcomes for children with pICH.

Journal of the American Heart AssociationVol. 15(1)
Cincinnati Children's Hospital Medical Center (US), Boston Children's Hospital (US), Centre National de la Recherche Scientifique (FR), Nationwide Children's Hospital (US), Children's Hospital of Philadelphia (US), University of Wisconsin–Madison (US), Harvard University (US), University of Alberta (CA), Inserm (FR), Tel Aviv University (IL), University of California, San Francisco (US), Wright State University (US), Nova Southeastern University (US), Université Paris Cité (FR), University of Michigan (US), United States Army Reserve (US), Garrahan Hospital (AR), Emory University Hospital (US), Hospital for Sick Children (CA), Hospital de Sant Pau (ES), Sorbonne Université (FR), Institut Necker Enfants Malades (FR), National Hospital (IN), Hospital Base (CL), Centre Hospitalier Universitaire de Tours (FR), Clinical Investigation Center Plurithematic Tours (FR), Laboratoire National de Référence (MA), Dayton Children's Hospital (US), Institut de Psychiatrie et Neurosciences de Paris (FR), Texas Children's Hospital (US), Hôpitaux de Saint Maurice (FR), Children's Hospital & Medical Center (US), Boston Children's Museum (US), Children's Health Queensland Hospital and Health Service (AU), Anderson University - South Carolina (US), University of Pennsylvania (US), Stanford University (US)
Partnerships for the goals
Openalex Percentile: Top 13%
Intracerebral and Subarachnoid Hemorrhage Research
1.39
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