Armghan Ans/LinkedIn

Mar 23, 2026, 17:28

Armghan Ans: Until Now Children Have Never Had a Guideline-Backed Treatment Pathway for Stroke

Armghan Ans, Asst. Professor and Director of Stroke at UPMC Washington, Founder of MDAdopt™, shared on LinkedIn:

”The 2026 AHA/ASA stroke guidelines include something that has never existed before.

Formal recommendations for treating stroke in children.

Alteplase is now recommended for ages 28 days to 18 years within 4.5 hours of disabling deficits.
EVT is now recommended for children 6 and older within 6 to 24 hours with salvageable tissue.

This is long overdue.

Pediatric stroke causes lifelong disability.

Children have never had a guideline-backed treatment pathway – until now.

Here is the part that keeps me up at night:

Annual childhood arterial ischemic stroke incidence in North America is approximately 1.3 to 1.72 per 100,000 children.
It is rare enough that most community emergency departments may go years without seeing a single case.

Which means when one arrives, the protocols don’t exist.

The pediatric neurology isn’t on call.

The neurointerventionalist with pediatric experience isn’t on staff.

The transfer agreement for pediatric EVT hasn’t been signed.

The guideline writing group called this ‘a remarkable shift that establishes the foundation for future research.’

The guideline itself acknowledges that much work remains to adapt protocols for pediatric patients.

That is a polite way of saying: the recommendation is here.

The infrastructure is years away.

Full article — all seven 2026 guideline changes and what they actually demand from hospitals on the front lines:

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